Advice: metastatic ca colon - Forum

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Hans

Re: Advice: metastatic ca colon - Ärzteforum

Post#11 »

I think 6 yrs is pretty good post op for Ca and if I am 85 and in good
health I shall be pretty satisfied. Something will come along soon and take
me away!


Proctologist

Re: Advice: metastatic ca colon - Ärzteforum

Post#12 »

It is important to have a good idea about the base-line sphincter function
of the patient. If he has good sphincter function, I will agree with the
ileoproctostomy decision. Only time will tell you if he will be one of the
many who had good functional outcome from the procedure. And remember, you
are not burning any bridges by accepting this option. I wish him all the
best.

Marcel

Re: Advice: metastatic ca colon - Ärzteforum

Post#13 »

Along the same vein, may I get a consensus on who would do a
metastasectomy on an 18 year male with metastatic osteosarcoma to the
the right lower lobe, right middle lobe and left apical lobes of the
lung. Patient is one year post hip disarticulation, primary appears
well controlled, no other foci. Is tumor debulking adviseable for
osteosarcoma prior to chemotherapy.

bonjorno

Re: Advice: metastatic ca colon - Ärzteforum

Post#14 »

Is convenient to resect metastasis of osteosarcoma .
Your Patient have two significant prognosis factor .
The first one is good because he is young ( below 46 Y.O.)
The second one is relatively adverse . The critical number is two( 45%
against 15% five years survaival rate )
I would operate by way of median sternotomy .
Does not necessary more that free margin for resection ( not indispensable
lobectomy or mor as condition to improve the prognosis ) .
Chemoterawpy after surgery .

Hans

Re: Advice: metastatic ca colon - Ärzteforum

Post#15 »

you can see 3 separate metastases, how many are there that you can't see -
too small or in another organ not so easily imaged as the lung. Just what
would you expect to achieve with surgery? This is surely widely disseminated
disease.

外科医生

Re: Advice: metastatic ca colon - Ärzteforum

Post#16 »

I agree completely, as long as he has
lung function to tolerate all of the procedures. I am not sure median
sternotomy would be the best approach, it depends if all of the nodules
are accessable through this incision, if not, sequential thoracotomies
would also be fine ( very posterior nodules sometimes make ressection
through sternotomy very hard).

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