Highly Advanced Colorectal Liver Metastases Successfully Treated With Fluorouracil Plus Leucovorin Monotherapy and Microwave Ablation

Abstract

Background: Fluorouracil plus leucovorin (5-FU/LV) is a less toxic but mild chemotherapy.

Case report: A 63-year-old male patient with rectal cancer and multiple colorectal liver metastases (CRLM, total volume of 1,826 ml) was hospitalized. He had several poor prognostic factors, including elevated levels of tumor markers, with carcinoembryonic antigen and carbohydrate antigen 19-9 levels of 17,119 ng/ml and 7,617 U/ml, respectively. Additionally, the patient had a low body mass index, poor performance status, and a history of apparent weight loss. After capecitabine and oxaliplatin for four cycles, 5-FU/LV has been lasting for nine months. Interestingly, tumor marker levels returned close to normal limits, and the total CRLM volume decreased to 154 ml without any enhancements. The patient's general condition clearly improved after a year of chemotherapy.

Conclusion: Chemotherapy with 5-FU/LV and percutaneous microwave ablation is beneficial to achieve tumor control in patients with highly advanced liver-only CRLM and poor general condition.

Keywords: Colorectal liver metastases; fluorouracil plus leucovorin; microwave ablation; systemic chemotherapy.