Abstract
The patient was a 47-year-old woman with sigmoid colon cancer and multiple hepatic metastases. The liver metastases were no less than 30 lesions, with a maximum diameter of 9 cm ; they were initially considered unresectable, and the patient was treated with FOLFOX + cetuximab. After 7 courses of chemotherapy, the liver metastases decreased in size significantly, and R0 resection with sigmoidectomy and the ALPPS procedure was planned. Laparoscopic sigmoidectomy, partial hepatectomy of the left liver lobe, cholecystectomy, right portal vein ligation, and in situ splitting were performed as the first operation. Then, 15 days later, extended right liver lobectomy was performed as the second operation after carefully examining remnant liver function. The patient's hospital course was uneventful, and she was discharged 16 days after the second operation. She is currently alive without recurrence for 1 year after the operation and is in the middle of receiving adjuvant chemotherapy of 5-FU/LV + bevacizumab. It is important to develop a plan with a multidisciplinary approach involving a colorectal surgeon, hepatobiliary surgeon, and medical oncologist to perform R0 resection and achieve a good prognosis.
