FOLFIRI Is Tolerable after Subtotal Colectomy – A Patient with Familial Adenomatous Polyposis Who Developed Advanced Rectal Cancer

A 40-year-old female with familial adenomatous polyposis (FAP) had a subtotal colectomy at 16 years of age. At 39 years, she had low anterior resection due to advanced rectal carcinoma. Thereafter, we administrated per os uracil and tegafur for 9 months. Metastatic rectal carcinoma was detected in the liver (S8) by computed tomography (CT). 2-[(18)F]-fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET) data did not show any other metastasis. This report presents a first case of a patient undergoing subtotal colectomy administered FOLFIRI (CPT-11 180 mg/m(2) as a 90-minute infusion on day 1; leucovorin 400 mg/m(2) as a 2-hour infusion during CPT-11, immediately followed by 5-FU bolus 400 mg/m(2) and 46-hour continuous infusion of 2,400 mg/m(2) every 2 weeks). This regimen was administered without grade 3 or 4 of any adverse reaction for 6 months, although there was a possibility that this patient with subtotal colectomy may have the cause for severe diarrhea. Further investigations are needed to assess the safety in clinical trials of FOLFIRI regimen for patients with subtotal colectomy.