title: Gastrojejunostomy followed by induction chemotherapy for incurable gastric cancer with outlet obstruction.
abstract: A 72-year-old male gastric cancer patient with outlet obstruction underwent laparoscopic exploration. The examination disclosed intraperitoneal free cancer cells with no overt peritoneal, lymphatic, or hepatic metastasis. The patient underwent laparoscopy-assisted gastrojejunostomy (LAGJ) and started chemotherapy with S-1 plus cisplatin on postoperative day 13. Three course of the chemotherapy shrank the tumor markedly. Then, the patient underwent gastrectomy with a curative intent. Laparotomy revealed no intraperitoneal free cancer cells, and microscopically complete resection was achieved. The patient received S-1 chemotherapy as postoperative adjuvant treatment for 1 year, and is still alive with no evidence of peritoneal recurrence. LAGJ followed by S-1 plus cisplatin is one of the optional treatments that should be considered for patients with outlet obstruction as it may widen opportunities for potentially curative resection.
authors.affiliation: Department of Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, 3-18-22 Honkomagome, Bunkyo-ku, Tokyo 113-8677, Japan.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Okumura
authors.forename: Manabu
authors.initials: M
authors.lastname: Ohashi
authors.forename: Souya
authors.initials: S
authors.lastname: Nunobe
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Iwanaga
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Kanda
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Iwasaki
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D004338:Drug Combinations; D015390:Gastric Bypass; D006801:Humans; D008297:Male; D010094:Oxonic Acid / Q000008:administration & dosage; D013274:Stomach Neoplasms / Q000150:complications / Q000628:therapy*; D005641:Tegafur / Q000008:administration & dosage
chemical_list: D004338:Drug Combinations; C079198:S 1 (combination); D005641:Tegafur; D010094:Oxonic Acid; D002945:Cisplatin
references.citation: Surgery. 1998 Mar;123(3):330-4
references.pmid: 9526526
references.citation: Eur J Cancer. 1998 Oct;34(11):1715-20
references.pmid: 9893658
references.citation: Surg Today. 2008;38(12):1102-7
references.pmid: 19039635
references.citation: Br J Surg. 1990 Apr;77(4):436-9
references.pmid: 2340396
references.citation: Hepatogastroenterology. 2008 Sep-Oct;55(86-87):1939-42
references.pmid: 19102427
references.citation: N Engl J Med. 2008 Jan 3;358(1):36-46
references.pmid: 18172173
references.citation: Eur J Surg Oncol. 2009 Nov;35(11):1158-63
references.pmid: 19328643
references.citation: Gastric Cancer. 2007;10(1):29-34
references.pmid: 17334715
references.citation: Gastric Cancer. 2006;9(2):129-35
references.pmid: 16767369
references.citation: Gastric Cancer. 1998 Dec;1(1):10-24
references.pmid: 11957040
references.citation: Surg Endosc. 2002 Nov;16(11):1620-6
references.pmid: 12073005
references.citation: Lancet Oncol. 2008 Mar;9(3):215-21
references.pmid: 18282805
references.citation: J Clin Oncol. 2006 Nov 1;24(31):4991-7
references.pmid: 17075117
references.citation: BMC Gastroenterol. 2007 Jun 08;7:18
references.pmid: 17559659