Conquering Stage IV Sigmoid Colon Cancer: A Six-Year Disease-Free Triumph

A 73-year-old male patient arrived at IUHW Shioya Hospital in Yaita, Japan, diagnosed with sigmoid colon cancer. Despite also managing type 2 diabetes with an HbA1c of 6.4%, he was deemed suitable for surgery. Initially, no distant metastases were detected. Surgeons proceeded with a laparoscopic sigmoidectomy, removing the affected portion of his large intestine. Pathological analysis confirmed a pT3N0M0 (stage IIA), moderately differentiated adenocarcinoma.

Over the following eight months, he regularly visited the outpatient clinic for close follow-up. Unfortunately, new imaging eventually revealed two liver metastases: a 17×14 mm lesion in segment 3 (S3) and a smaller 2×1 mm spot in segment 5 (S5). Determined to address these tumors, his surgical team employed intraoperative ultrasonography to accurately locate both lesions. They then performed a local resection, effectively removing the cancerous tissue from his liver.

After recovering from the hepatic surgery, the patient began a six-month course of FOLFOX chemotherapy, consisting of folinic acid (200 mg/m²), a fluorouracil bolus (400 mg/m²) plus continuous intravenous infusion (2,400 mg/m²), and oxaliplatin (85 mg/m²). He completed a total of 10 treatment cycles, ensuring that any microscopic cancer cells were dealt with aggressively.

Now, over 2,400 days (more than six years) since his liver resection, the patient continues to show no evidence of disease. He maintains a careful follow-up schedule, returning to the clinic every month or two for comprehensive checkups and imaging tests. His experience underscores the importance of vigilant surveillance, the benefits of laparoscopic techniques for colon surgery, and the potential of a well-coordinated treatment plan—even in the face of comorbidities like diabetes.