Abstract

A 61-year-old white man presented with a stenosing tumour of the right colon and a large hepatic metastasis measuring 90 mm in its largest diameter, judged not suitable for immediate resection. He underwent right hemicolectomy and received 12 cycles of treatment with 5-fluorouracil/leucovorin, oxaliplatin and irinotecan (FOLFOXIRI) plus bevacizumab. According to Response Evaluation Criteria in Solid Tumors (RECIST criteria), he achieved a partial response that allowed a secondary radical hepatic resection. Pathologic examination of the liver specimen showed the absence of residual tumour cells: a pathologic complete response (pCR) was achieved. In this case, an intensive up-front treatment (i.e. the combination of FOLFOXIRI plus bevacizumab) produced the pCR of a liver metastasis from colorectal cancer despite its initial large dimension while confirming the possible discrepancy between radiologic assessment and pathological findings.

Keywords: Metastatic colorectal cancer, liver resection, preoperative chemotherapy, bevacizumab, FOLFOXIRI, complete pathologic response.