[A case of liver metastases from gastric cancer successfully treated with induced hypertensive chemotherapy].
We report a 77-year-old patient with gastric cancer who has survived 5 years after multidisciplinary treatment for both liver and brain recurrences. He underwent a D2 distal gastrectomy for macroscopically type 2 cancer at the lower third of the stomach on May 1997. The histopathological findings were as follows: O-IIc (SM2), poorly differentiated adenocarcinoma, pN2, ly2, v2, stage II. One year after surgery, a follow-up abdominal CT scan revealed multiple liver metastases. He received both hepatectomy and prophylactic hepatic arterial infusion of mitomycin C with induced hypertensive chemotherapy (IHC), a drug delivery system using the difference in blood flow between normal and tumor vessels by intravenously injected angiotensin-II. IHC was carried out monthly and the total dose of MMC was 74 mg (6 courses). Although he was disease-free for about 2 years, brain metastases were found on December 2000. He then underwent excision of the brain metastases and consecutive radiation by X-knife. Although he had a relapse of liver metastases on April 2002, he is still alive now. We consider multidisciplinary treatment including complete surgical resection as effective, even for recurrent or highly malignant gastric cancer.
Katayanagi
Soh
S
Dept. of Surgery, Tokyo Metropolitan Komagome Hospital.
Arai
Kuniyosi
K
Iwasaki
Yoshiaki
Y
Takahashi
Keiichi
K
Yamaguchi
Tatsurou
T
Matsumoto
Hiroshi
H
Miyamoto
Hidenori
H
D000368:Aged; D000804:Angiotensin II / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects*; D001932:Brain Neoplasms / Q000556:secondary / Q000601:surgery; D003131:Combined Modality Therapy; D004334:Drug Administration Schedule; D004338:Drug Combinations; D005743:Gastrectomy; D006498:Hepatectomy; D006499:Hepatic Artery; D006801:Humans; D007269:Injections, Intra-Arterial; D008113:Liver Neoplasms / Q000188:drug therapy / Q000556:secondary* / Q000628:therapy*; D008297:Male; D016685:Mitomycin / Q000008:administration & dosage; D011509:Proteoglycans / Q000008:administration & dosage; D016634:Radiosurgery; D013274:Stomach Neoplasms / Q000473:pathology* / Q000601:surgery; D005641:Tegafur / Q000008:administration & dosage; D014498:Uracil / Q000008:administration & dosage
D004338:Drug Combinations; D011509:Proteoglycans; C096910:UFT(R) drug; D000804:Angiotensin II; D005641:Tegafur; C010770:polysaccharide-K; D016685:Mitomycin; D014498:Uracil