A Case of Locally Advanced Rectal Cancer Treated with Radical Resection after mFOLFOX6 Chemotherapy

Abstract

An 81-year-old man was admitted with general malaise and constipation. Colonoscopy showed a type 2 circular tumor 5cm from the anal verge. CT and MRI showed signs of invasion in the prostate and the sacrum (cT4b). Because he had bowel obstruction symptoms, we firstly constructed a colostomy.After that, six cycles of mFOLFOX6 systemic chemotherapy was administered. CT and MRI after chemotherapy showed reduction in tumor size and disappearance of tumor invasion. Seven weeks after chemotherapy, he underwent abdominoperineal resection without any other organ resection. Histological examination revealed negative margin. Tumor regression grading of chemotherapy was Grade 2. At the follow-up 20 months after surgery, he was alive without recurrence. With our present experience, we consider that mFOLFOX6 preoperative chemotherapy regimen could have a local effect comparable with chemo radiation for locally advanced rectal cancer.