A case with synchronous multiple liver metastases from gastric carcinoma: postoperative long-term disease-free survival.
OBJECTIVE
We herein report a case with synchronous multiple liver metastases from gastric carcinoma surviving disease-free for more than 10 years after hepatic resection.


METHODS
A 64-year-old male admitted to our hospital because of constitutional wariness. Preoperative diagnosis was type 1 gastric cancer at the lower third of the stomach and multiple metastases of both hepatic lobes. After we performed distal gastrectomy with regional lymphadenectomy and wedge hepatic resection for eight metastatic liver tumors, he received 5-fluoropyrimidine and platinum-based adjuvant chemotherapy during the early postoperative period.


RESULTS
The pathologic examination revealed moderately differentiated gastric adenocarcinoma with regional lymph node metastasis and multiple liver metastases. The postoperative course was uneventful and the patient is doing well without disease recurrence after more than 10 years following surgery.


CONCLUSIONS
To the best of our knowledge, this patient is the longest disease-free survivor after liver resection for synchronous multiple liver metastases from advanced gastric cancer. In this modern era of developing liver surgery and adjuvant chemotherapy, combination therapy of aggressive surgery and early postoperative adjuvant chemotherapy for advanced gastric cancer with liver metastasis may allow long-term survival in selected patients.
Munekage
Masaya
M
Department of Surgery, Kochi Medical School, Kohasu-Okocho, Nankoku-City, Kochi, 783-8505, Japan.
Okabayashi
Takehiro
T
Hokimoto
Norihiro
N
Sugimoto
Takeki
T
Maeda
Hiromichi
H
Namikawa
Tsutomu
T
Dabanaka
Ken
K
Kobayashi
Michiya
M
Araki
Keijiro
K
Hanazaki
Kazuhiro
K
D000230:Adenocarcinoma / Q000188:drug therapy / Q000556:secondary* / Q000601:surgery; D018572:Disease-Free Survival; D005743:Gastrectomy; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000188:drug therapy / Q000556:secondary* / Q000601:surgery; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D011743:Pyrimidines / Q000627:therapeutic use; D013274:Stomach Neoplasms / Q000473:pathology* / Q000601:surgery; D013997:Time Factors
D011743:Pyrimidines; C029269:5-fluoropyrimidine