Long-term outcome of laparoscopic resection for stage IV colorectal cancer.

Laparoscopic surgery is recommended as an initial stage IV colorectal cancer therapy. A 57-year-old male with sigmoid colon cancer and two hepatic metastases underwent laparoscopic sigmoidectomy with lymph adenectomy. He was orally administered postoperative Tagafur/Uracil/leucovorin therapy for 10 months. However, because of regrowth of the liver metastasis he was administered leucovorin/bolus and infusional 5-fluorouracil/irinotecan therapy for 10 months followed by extended left lobectomy of the liver and the above mentioned chemotherapy was continued for 6 months. He was diagnosed with S6 and S6/7 hepatic recurrent tumor, which were resected 14 months after the second and another 14 months after the third surgery, respectively. Forty-two months following complete response after the fourth surgery, S6 hepatic recurrent tumor was resected. Six months after the fifth surgery, he developed multiple liver metastases. He was treated successfully using leucovorin/bolus and infusional 5-fluorouracil/oxaliplatin and bevacizumab. He is alive 9 years and 3 months after initial surgery.