Clin Endosc.  2019 Mar;52(2):191-195. 10.5946/ce.2018.088.

Is it Possible to Successfully Treat Locally Advanced Colon Cancer Using Pre-Operative Chemoradiotherapy?

• Choi JH
• Kim JH
• Moon W
• Lee SH
• Baek SU
• Ahn BK
• Park JG
• Park SJ

• KMID: 2447678
• DOI: http://doi.org/10.5946/ce.2018.088

Abstract

Pre-operative chemoradiotherapy (CRT) is a preferable treatment option for patients with locally advanced rectal cancer. However, few data are available regarding pre-operative CRT for locally advanced colon cancer. Here, we describe two cases of successful treatment with pre-operative CRT and establish evidence supporting this treatment option in patients with locally advanced colon cancer. In the first case, a 65-year-old woman was diagnosed with ascending colon cancer with duodenal invasion. In the second case, a 63-year-old man was diagnosed with a colonic-duodenal fistula due to transverse colon cancer invasion. These case reports will help to establish a treatment consensus for pre-operative CRT in patients with locally advanced colon cancer.

Keyword

Colon cancer duodenal invasion; Locally advanced colon cancer; Pre-operative chemoradiotherapy

MeSH Terms

Aged
Chemoradiotherapy*
Colon*
Colon, Ascending
Colon, Transverse
Colonic Neoplasms*
Consensus
Female
Fistula
Humans
Middle Aged
Rectal Neoplasms

Figure

• 

  Fig. 1. (A) Abdominal computed tomography revealed fat stranding around the ascending colon with irregular wall thickening and a 1.5-cm, low-density lesion on the duodeno-pancreatic groove (black arrowhead). (B) Colonoscopic examination showed an ulcero-infiltrative mass with luminal narrowing. (C) Upper endoscopic examination showed a large exophytic mass with obstruction in the second portion of the duodenum.

• 

  Fig. 2. (A) Abdominal computed tomography revealed reduced irregularly enhancing wall thickening at the ascending colon. (B, C) Colonoscopic and upper endoscopic examination revealed significantly reduced tumors compared to previous studies.

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  Fig. 3. (A) Computed tomography image showing a large irregular mass at the transverse colon extending to and invading the duodenum. (B) Colonoscopic images showed poorly circumscribed infiltrating masses with ulceration in the transverse colon. (C) Upper endoscopic examination showed a 2-cm fistula tract covered with yellowish exudates.

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  Fig. 4. Abdominal computed tomography revealed decreased size of the enhancing lobulated mass in the transverse colon and alleviated invasion of the adjacent anterior abdominal wall and duodenum (A). Upper endoscopic examination showed that the fistula opening was closed and replaced with a white scar (B).

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