Long Term Survival of a Patient with Metastatic Rectal Cancer Treated with Oral Regorafenib - A Case Report

A 56-years-old female had a history of radical proctectomy for carcinoma of rectum on 2003/4/29. Pathology report was Dukes’ C adenocarcinoma with 12 of 24 lymph node showing metastasis. She was managed to have six months of adjuvant chemotherapy of 5- fluorouracil with leucovorin. Computed Tomography (CT) scan on 2013/4/16 was reported as having recurrent tumor in left presacral region with. associated left hydronephrosis and hydroureter. 5400 cGy of radiotherapy was given. CT scan on 2013/8/14 was reported as decreased size of recurrent tumor in left presacral region as compared to last CT with persistent left hydronephrosis and hydroureter due to tumor invasion of middle left ureter. She was then arranged to have chemotherapy of capecitabine, irinotecan oxaliplatin, uracil-futrafur with bevacizumab and Ziv-Aflibercept. Above knee amputation of left leg was performed on 2016/3/29 following poor result of fasciectomy for necrotizing fasciitis. CT scan on 2016/6/6 was reported as interval stable of presacral and left pelvic wall soft tissue mass with calcification, associated left hydronephrosis and hydroureter. 160 mg per day of regorafenib was started from 2016/7/14. She was taking regorafenib regularly in the past three years and 6 months with stable disease. Her last CT scan on 2019/12/27 was reported as stationary appearance of the calcified soft tissue lesion in left presacral region with ipsilateral hydronephroureter and obliteration ipsilateral common iliac vein with prominent venous collaterals in anterior wall of pelvis and with mild left thigh edematous change.