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CASE Presentation
Dr Catherine Nyongesa Head Cancer Treatment Centre KNH, CEO Texas Cancer Centre
40 YR OLD MALE , Ca Rectum
FIRST VISIT 17-JUL-2017 1/12 POST OP
POST ENDOSCOPY WHICH SHOWED RECTAL ULCER
CASE Presentation Dr Catherine Nyongesa Head Cancer Treatment - - PowerPoint PPT Presentation
CASE Presentation Dr Catherine Nyongesa Head Cancer Treatment - - PowerPoint PPT Presentation
CASE Presentation Dr Catherine Nyongesa Head Cancer Treatment Centre KNH, CEO Texas Cancer Centre 40 YR OLD MALE , Ca Rectum FIRST VISIT 17-JUL-2017 POST ENDOSCOPY WHICH HISTOLOGY DIFFUSE SHOWED RECTAL ULCER TYPE ADENOCARCINOMA 1/12 POST
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status
- PMHX- NIL SIG
- NO CORMOBIDITIES
- NO FAMILY HISTORY
- Good ECOG 1
- PR-NED
- OTHER SYSTEMS NAD
- METASTATIC WORK UP NEG
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treatment
Wide local excision 23/06/2017 moderately differentiated adenocarcinoma, margins free of tumor RS/CVS/CNS NAD Adjuvant treatment dxt + chemo 1st and last week of dxt
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issues
T2N0M0 Signet ring adenocarcinoma grade 3 Young patient No nodal sampling Surgeon was worried and strongly recommended adjuvant treatment
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treatment
5FU BOLUS 788MG 5FU INFUSION 4728MG LEUCOVORIN 788MG + DXT 50.4Gy/28# CHEMO 2 CYCLE 1ST AND LAST WK OF DXT
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More chemotherapy
Adjuvant chemo continued CAPOX Oxaliplatin 230MG D1 Capecitabine 1500mg bd 14/7 Continue to total 6 cycles
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Last scan 17/01/2019
- Left rectal wall nodular thickening which abuts
the left meso rectal fascia.
- Mild surrounding fat stranding? Post treatment
changes or recurrence.
- Clinically NED.
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Duration of adjuvant chemo
- Follow up unreliable, returned to his home
country.
- Now 1.5 years post op
- Raising funds for endoscopy
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adverse features
- On pathology, TEM plus salvage (or adjuvant)
CRT in perioperative high-risk patients (but unproven benefit—with high risk of local recurrence for pT2)
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