The original plan was to have colon surgery, liver surgery, then chemo. However, there were a couple detours along the way. A secondary colon tumor was found after he had a left hemicolectomy. He went to Mass General for a combined sub-total colectomy and liver resection but the liver portion of the procedure was aborted while he was on the operating table when the liver surgeon saw that one of his two liver tumors was too close to a blood vessel to be done laparoscopically. The subtotal colectomy was completed (to do both under a converted open surgery would have been too much). So the plan was revised to do 4 rounds of chemo (6 weeks post subtotal colectomy), and then do the liver surgery. If the problematic tumor shrinks enough to do done laparoscopically, then that's how it will be done. Otherwise, he'll have open surgery. This will be a month or so after his 4th round of chemo which is scheduled for December 13.
On a side note, interestingly, the original tumor taken out in May (descending left colon) was the primary tumor. It had spread to 9 out of 54 nodes. The other tumor (T1) removed six weeks ago, at the juncture of the right and transverse colon, had not even become a T2 tumor, hadn't invaded through the colon wall, and no lymph nodes were cancerous. This means that his cancer essentially was/is a LEFT side cancer, which has different properties from RIGHT sided colon cancers.
Wife 4/17 Dx age 45
5/17 - Lap left hemi
5 x 4 x 1 cm
T3 N2b M1a
Stage IV A
lymph nodes: 9 of 54
8/17 Sub-total colectomy
2nd tumor 5.5 cm T1 N0
CEA: 1.4, 2.1, 1.5, 1.9, 1.9, 2.1, 2.1, 2.4, 1.7, 2.0, 2.9, 2.2
Lynch no; KRAS wild
Immunohistochemsistry: Normal MLH1, MSH2, MSH6, and PMS2
Tumor DNA variants: MTOR, APC, TP53
1/18 Liver left hepatectomy seg 4
5/18 CT clear
12/18 MRI shows met
Resection & HAI Mar 7??