Chennai’s MGM Healthcare Hospital has announced the successful outcome of a complex innovative multimodal procedure for multiple Synchronous Liver Metastases in a Stage 4 colorectal cancer patient. As per the hospital, it is probably the first time in the country that such a complex stage 4 colorectal cancer was operated in a single sitting.
Madhavi Muralidharan, a 60-year-old lady from Chennai was diagnosed with stage 4 cancer junction of colon and rectum (large intestine) with multiple metastatic spread in the liver (9 lesions in different areas occupying most of the liver). She also experienced weight loss and loss of appetite further hampering her physical movements. She travelled to different cancer hospitals and was informed that her disease is not curable and that she had only a few months left to live.
Her family was then advised to consult Dr. Thiagarajan Srinivasan, Director, Institute of liver transplant and GI surgery, MGM Healthcare, Chennai. Dr. Thiagarajan, after a thorough analysis of the case, informed the patient and her family that the cancer could be cured with an innovative treatment and she was asked to follow-up with Dr. Arun Ramanan, medical oncologist for further treatment. The family, after consultation with the doctors at MGM Healthcare, gave their consent for the complex surgery.
Elaborating about the case, Dr. Thiagarajan said, “We decided to go ahead with a single stage surgery for a complex synchronous liver metastasis and the rectal cancer of the patient. We recreated the surgery through 3D volumetry of the lesions and future liver remnant and 3D reconstruction was undertaken by an expert radiologist team. A detailed 3D simulation of surgical removal all the nine liver lesions was virtually undertaken by the team before the surgery because excess removal of liver would have led to liver failure and inadequate removal of lesions will cause recurrence of cancer and reduce the lifespan of the patient.”
He further added, “The patient underwent a single stage removal of all nine lesions of liver and removal of cancer of colon and rectum with a diversion stoma. She underwent post-operative biological tumor antibody therapy and cancer chemotherapy for 6 months. We are happy to report that a rigorous follow-up of 8 months, the patient is completely cured of the cancer with no detectable tumour in whole of her body which was confirmed by a PETCT scan.”
Colorectal cancer is the sixth commonest cancer in India, with 5 new cases occurring for every one lakh persons in a year with incidence rising by 20% every decade. Stage-1 colorectal cancer has 90% 5-year survival after multimodal therapy whereas stage-4 colorectal cancer has only 10% 5-year survival rate. The rising cases can be attributed to changing lifestyles that include consumption of calorie-rich and low fibre diet, excessive use of red meat and processed foods, and physical inactivity.
Dr. Karthik Mathivanan, Associate Director, MGM Healthcare said, “Colorectal cancer is the 5th leading cause of cancer death in India as most of the cases are diagnosed in advanced stage. 20-25% of the colorectal cancer patients present with liver metastases. As liver has the capacity to regenerate extensive liver resection up to 70% is possible for multiple liver lesions and to have curative surgery is a feasible option. There is lack of awareness and we recommend routine annual screening for people above 45 years with a colonoscopy that will help us nip it in the bud. It’s unfortunate that only <5% of the adult population are screened annually in the country.”