ONCAlert | 2017 San Antonio Breast Cancer Symposium
Colorectal Cancer Case Studies

Case Studies: Recurrent Colon Cancer with Liver Metastases

In this case-based interview series, Tanios Bekaii-Saab, MD, FACP, discusses the treatment of a patient who develops recurrent metastatic adenocarcinoma of the colon.

Recurrent Colon Cancer with Liver Metastases

November 2012

  • A 51-year-old man was referred to gastroenterology for screening colonoscopy.
  • Family history includes pancreatic cancer on his father’s side and pre-menopausal breast cancer in his aunt.
  • Colonoscopy revealed a 3-cm mass, proximal to the hepatic flexure.
  • Biopsy confirmed the lesion to be of adenocarcinoma histology.
  • At the time, the patient underwent right hemicolectomy revealing a moderately differentiated tumor. Fifteen lymph nodes were removed and tested negative for metastatic disease, denoting stage T3N0M0 colon cancer.
  • The patient healed without complications and received no further treatment.

April 2015

  • The patient continued to feel well, except for occasional fatigue and diarrhea.
  • Routine evaluation showed elevated carcinoembryonic antigen.
  • PET/CT scan revealed several small lesions in multiple lobes of the liver that were PET avid
  • Biopsy was performed and confirmed the liver lesions to be metastases from colon cancer
  • The patient was referred to a local oncologist and started on infusional 5-FU and oxaliplatin (FOLFOX) in combination with bevacizumab.
  • CT scan 2 months after starting treatment showed a partial response to therapy; at 4 months the patients tumor continued to shrink
  • Oxaliplatin was discontinued; subsequently the patient received maintenance therapy with capecitabine and bevacizumab, resulting in continued disease control

February 27, 2017

  • The patient has had stable disease for 22 months and remains on bevacizumab maintenance therapy.
  • He appears generally well and free of symptoms.
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