[Two Cases of Surgical Treatment for Disseminated Gastric Carcinoma]

Gan To Kagaku Ryoho. 2018 Dec;45(13):2378-2380.
[Article in Japanese]

Abstract

Case 1: A 75-year-old man underwent distal gastrectomy with Billroth Ⅰ reconstruction and resection of the involved transverse mesocolon. Microscopic examination revealed adenocarcinoma(tub2, tub1), pT4b(SI)N3M0, pStageⅢc. Adjuvant chemotherapy with S-1 was performed for 6 months after the operation. One year later, CT revealed a localized dissemination in the transverse mesocolon; therefore, we performed transverse colectomy. Adjuvant chemotherapy with PTX was performed, and the patient remains free from recurrence 7 years after the initialoperation. Case 2: A 65-year-old man was diagnosed with gastric scirrhous carcinoma by esophagogastroduodenoscopy. CT and colonoscopy showed a tumorous lesion in the pelvis(Schnitzler's metastasis). Neo-adjuvant chemotherapy with S-1 plus CDDP was performed. After 6 courses, CT and endoscopy showed shrinkage of the tumors, and no other distant metastasis was detected by PET-CT. We performed totalgastrectomy(D2), splenectomy, and low anterior resection of the rectum simultaneously. Microscopic examination revealed adenocarcinoma(tub2, por2, sig), pT4a(SE)N0, and the histological response was Grade 1a. S-1 was administered, and the patient has had no recurrence in the 1 year 6 months after the operation. Dissemination of gastric cancer tends to be difficult to treat and has a poor prognosis. However, in some cases, the proper combination of chemotherapy and surgery might be beneficial for long survival.

Publication types

  • Case Reports

MeSH terms

  • Adenocarcinoma* / drug therapy
  • Adenocarcinoma* / pathology
  • Adenocarcinoma* / surgery
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Chemotherapy, Adjuvant
  • Drug Combinations
  • Gastrectomy
  • Humans
  • Male
  • Neoplasm Recurrence, Local
  • Oxonic Acid / administration & dosage
  • Positron Emission Tomography Computed Tomography
  • Stomach Neoplasms* / drug therapy
  • Stomach Neoplasms* / pathology
  • Stomach Neoplasms* / surgery
  • Tegafur / administration & dosage

Substances

  • Drug Combinations
  • S 1 (combination)
  • Tegafur
  • Oxonic Acid