[A Case of Long-Term Survival with Far Advanced Gastric Cancer after Multidisciplinary Treatments, including Conversion Surgery]

Gan To Kagaku Ryoho. 2020 Mar;47(3):545-547.
[Article in Japanese]

Abstract

An 82-year-old man with Stage Ⅳ advanced gastric cancer and multiple liver metastases was referred to our hospital. Chemotherapy using S-1 was administered, resulting in withdrawal from the usual course because of an adverse event of grade 4 anorexia. GIS and EOB-MRI showed a prominent tumor reduction in both lesions; however, despite this, distal gastrectomy, D2 lymph node dissection, liver biopsy for S3 lesion, partial liver resection for S6 lesion, and cholecystectomy were performed to obtain a therapeutic diagnosis. Pathology revealed that the tumor cells remained in the main liver metastatic lesions. Therapeutic effect was assessed as Grade 2. Although weekly paclitaxel followed by reduced S-1 dosage was introduced after surgery, the recurrent mass was observed in the para-aortic region after 2 years. Subsequently, para-aortic lymph node dissection was performed because no new lesion was detected. More than 10 years have passed without any recurrence since the first surgery. As part of a multidisciplinary treatment for far advanced gastric cancer with multiple liver metastases (Stage Ⅳ), conversion surgery might be considered effective.

Publication types

  • Case Reports

MeSH terms

  • Aged, 80 and over
  • Antineoplastic Combined Chemotherapy Protocols
  • Humans
  • Lymphatic Metastasis
  • Male
  • Neoplasm Recurrence, Local
  • Oxonic Acid
  • Stomach Neoplasms* / surgery
  • Tegafur

Substances

  • Tegafur
  • Oxonic Acid