PDF(Pubmed)
Abstract：
BACKGROUND: Treatment options for advanced colon cancer are mainly combinations of chemotherapy and targeted drugs. However, poor physical health and medication intolerance limit the choice of anticancer drugs. Colon cancer with cirrhosis is a particular patient group that poses a challenge to clinical treatment.
METHODS: This article presents a case of a patient in the decompensated stage of cirrhosis who was diagnosed with advanced colon cancer. The initial presentation was a nodule on his navel named the Sister Mary Joseph\'s nodule, which was later confirmed by biopsy and PET-CT as one of the metastases of colon cancer. The patient was treated with cetuximab and 5-fluorouracil at a below-guideline dose; however, portal vein thrombosis developed and led to death. This entire process, from diagnosis to death, occurred within a span of three months.
CONCLUSIONS: Cancers with cirrhosis are a special group that deserves more attention. There is no unified treatment guideline for these patients, especially those with extrahepatic primary tumors. We should be more cautious when choosing treatment for such patients in the future. Both chemotherapy and targeted treatment may potentially induce portal vein thrombosis, which appears to have a higher incidence and worse prognosis than cancers without cirrhosis.
METHODS: This article presents a case of a patient in the decompensated stage of cirrhosis who was diagnosed with advanced colon cancer. The initial presentation was a nodule on his navel named the Sister Mary Joseph\'s nodule, which was later confirmed by biopsy and PET-CT as one of the metastases of colon cancer. The patient was treated with cetuximab and 5-fluorouracil at a below-guideline dose; however, portal vein thrombosis developed and led to death. This entire process, from diagnosis to death, occurred within a span of three months.
CONCLUSIONS: Cancers with cirrhosis are a special group that deserves more attention. There is no unified treatment guideline for these patients, especially those with extrahepatic primary tumors. We should be more cautious when choosing treatment for such patients in the future. Both chemotherapy and targeted treatment may potentially induce portal vein thrombosis, which appears to have a higher incidence and worse prognosis than cancers without cirrhosis.
摘要：
背景：晚期结肠癌的治疗选择主要是化疗和靶向药物的组合。然而,身体状况不佳和药物不耐受限制了抗癌药物的选择。结肠癌肝硬化是一个特殊的患者群体，对临床治疗提出了挑战。
方法：本文介绍一例肝硬化失代偿期患者，诊断为晚期结肠癌。最初的演讲是他肚脐上的一个结节，命名为玛丽·约瑟夫修女的结节，后来通过活检和PET-CT证实为结肠癌的转移之一。患者接受西妥昔单抗和5-氟尿嘧啶治疗，剂量低于指导剂量；然而，门静脉血栓形成并导致死亡。这整个过程,从诊断到死亡,发生在三个月内。
结论：肝硬化是一个值得关注的特殊群体。这些患者没有统一的治疗指南，尤其是肝外原发性肿瘤。今后在为此类患者选择治疗时，我们应该更加谨慎。化疗和靶向治疗都可能导致门静脉血栓形成，与没有肝硬化的癌症相比，这种癌症的发病率更高，预后更差。
方法：本文介绍一例肝硬化失代偿期患者，诊断为晚期结肠癌。最初的演讲是他肚脐上的一个结节，命名为玛丽·约瑟夫修女的结节，后来通过活检和PET-CT证实为结肠癌的转移之一。患者接受西妥昔单抗和5-氟尿嘧啶治疗，剂量低于指导剂量；然而，门静脉血栓形成并导致死亡。这整个过程,从诊断到死亡,发生在三个月内。
结论：肝硬化是一个值得关注的特殊群体。这些患者没有统一的治疗指南，尤其是肝外原发性肿瘤。今后在为此类患者选择治疗时，我们应该更加谨慎。化疗和靶向治疗都可能导致门静脉血栓形成，与没有肝硬化的癌症相比，这种癌症的发病率更高，预后更差。
