2016 Volume 69 Issue 2 Pages 101-107
A 66-year-old female underwent laparoscopic high anterior resection for recto-sigmoid colon cancer. During routine follow-up with no adjuvant chemotherapy, she had a complaint of bloody stool 9 months postoperatively.
Digital examination and colonoscopy showed a 2 cm tumor on the anastomotic site with the same pathological findings as a primary tumor (tub2). Radiologic examination showed lateral lymph nodes (LLNs) swelling. Under detailed informed consent, we planned preop-chemotherapy (mFOLFOX6) without radiotherapy for local control. After the completion of 6 cycles of mFOLFOX6, radiologic examination revealed remarkable reduction of the recurrent tumor and LLNs. She underwent salvage surgery including LLNs dissection with temporary ileostomy 16 months after the primary surgery.
The pathology report showed no malignancy with postop-scar, which meant pCR. After the surgery, she received 6 cycles of adjuvant mFOLFOX6, and then the temporary ileostomy was closed. She remains well 3 years after the salvage surgery.
Neoadjuvant chemotherapy without radiation followed by radical surgery is the other modality for anastomotic recurrence after rectal cancer surgery.
