A Case of Rectal Cancer Successfully Treated with Neoadjuvant Chemotherapy after Inserting a Stent and Securing a Circumferential Resection Margin

Abstract

We report a case of locally far-advanced rectal cancer resected by laparoscopic surgery after colonic stent insertion and neoadjuvant chemotherapy. A 67-year-old man with a complaint of anorexia and weight loss visited our hospital in July 2019.

CT revealed a huge rectal tumor. Lower gastrointestinal endoscopy showed circumferential stenosis due to rectal cancer. Insertion of a self-expanding metallic stent for obstructive rectal cancer alleviated the patient's symptoms quickly．Six courses of neoadjuvant chemotherapy (mFOLFOX6) were administered. After chemotherapy, the tumor was markedly reduced and it was considered that the tumor could be radically resected, so laparoscopic surgery was performed. Combination therapy with colonic stenting and neoadjuvant chemotherapy can be an effective treatment for obstructive rectal cancer. It was possible to secure a circumferential resection margin (CRM). This case is considered to be one of the therapeutic strategies for locally advanced rectal cancer.