A Successful Case of Intersphincteric Resection for Locally Advanced Rectal Cancer after mFOLFOX6 and Bevacizumab Therapy

A man in his fifties with ileus caused by rectal cancer underwent transverse colostomy and insertion of CV catheter. On the 7th postoperative day, systemic chemotherapy by mFOLFOX6 (bolus and infusion fluorouracil and leucovorin with oxaliplatine) was started via the CV port. From the second course, bevacizumab was combined with mFOLFOX6. After 5 courses with mFOLFOX6 and Bevacizumab, the rectal cancer was remarkably reduced in size and the serum levels of CEA and CA19-9 decreased to their normal levels. Laparoscopic intersphincteric resection for rectal cancer was performed safely. The histological effect of the chemotherapy was Grade 2. The surgical margin was free from cancer cells and lymph node metastasis was not present. The patient was treated with adjuvant chemotherapy without any recurrence for 9 months. This case suggests that neoadjuvant chemotherapy with mFOLFOX6/Bevacizumab is a useful regimen for locally advanced rectal cancer.