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 OP

status • PMHX- NIL SIG • NO CORMOBIDITIES • NO FAMILY HISTORY • Good ECOG 1 • PR-NED • OTHER SYSTEMS NAD • METASTATIC WORK UP NEG

Wide local excision 23/06/2017 moderately differentiated adenocarcinoma, margins free of tumor treatment RS/CVS/CNS NAD Adjuvant treatment dxt + chemo 1st and last week of dxt

issues Surgeon was worried and Signet ring strongly No nodal Young patient adenocarcinoma T2N0M0 recommended sampling grade 3 adjuvant treatment

5FU BOLUS 788MG 5FU INFUSION 4728MG LEUCOVORIN 788MG treatment + DXT 50.4Gy/28# CHEMO 2 CYCLE 1ST AND LAST WK OF DXT

Adjuvant chemo CAPOX continued More chemotherapy Capecitabine 1500mg bd Oxaliplatin 14/7 230MG D1 Continue to total 6 cycles

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.

Duration of adjuvant chemo • Follow up unreliable, returned to his home country. • Now 1.5 years post op • Raising funds for endoscopy

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)

THANK YOU !!!