An astonishing case of liver-only metastatic colorectal cancer cured by FOLFOXIRI alone

The array of tools currently available and the aim of treatment make choosing the best therapeutic strategy in metastatic colorectal cancer (CRC) an increasing challenge worldwide. We present the case of a 53-year-old man with metachronous metastases (liver-only metastatic disease) treated with FOLFOXIRI as first-line treatment. In March 2010, a colonoscopy carried out for persistent constipation revealed a neoplastic stenosing mass. After a month, the patient underwent a low anterior rectal resection with colorectal anastomosis; no metastases were found on the computed tomography scan. Histology confirmed adenocarcinoma (pT3N0M0; stage IIA). No adjuvant treatment was given because of the absence of negative prognostic and molecular factors in stage II. After 6 months of follow-up, a computed tomography scan and 18F-FDG PET showed five focal hepatic lesions. We decided to start a FOLFOXIRI regimen aimed at conversion. The patient had a complete clinical and radiological response to chemotherapy after eight cycles. After 7 years, the patient is currently without any evidence of recurrence or progression of the disease. Few literature reports suggest that chemotherapy alone can cure patients with CRC liver metastases. Although regimens including oxaliplatin have never been reported as potential healing tools, the FOLFOXIRI chemotherapeutic schedule (oxaliplatin, irinotecan, and 5-fluorouracil) showed a high response rate in mCRC and can even cure the metastatic disease in sporadic cases. Correspondence to Giovanni Brandi, MD, PhD, Department of Experimental, Diagnostic and Specialty Medicine, S. Orsola-Malpighi University Hospital, via Massarenti 9, 40138 Bologna, Italy Tel: +39 512 143 838; fax: +39 516 363 815; e-mail: giovanni.brandi@unibo.it Received October 10, 2018 Accepted January 18, 2019 Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.

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