title: [Long-term disease-free survival following multimodal treatment in a patient with curatively unresectable advanced gastric cancer with metachronous liver metastasis].
abstract: A case was a 57-year-old man. Despite a diagnosis of cStage IV gastric cancer (cN2, cH0, cM0, cT3 (SE), cP1), we preferentially performed a non-curative surgery to avoid stenosis or bleeding by tumor invasion. Since no evidence of peritoneal metastasis was found at surgery, distal gastrectomy with D2 lymph node dissection was performed, and lymph nodes anterior to the pancreatic head were sampled. The pathological diagnosis was pT3 (SE), pN2, sH0, pM1 (LYM), pStage IV. After the surgery, S-1 was administered. One year and 9 months later, a solitary metastasis was found in S6 of the liver, and the patient underwent radiofrequency ablation (RFA) followed by adjuvant S-1. Currently, 5 years and 10 months after the surgery, the patient is under follow-up, and remains alive with recurrence-free. We speculate that in the presence of N or M (LYM) factors for stage IV gastric cancer, surgery with lymphadenectomy, which does not prevent the completion of adjuvant chemotherapy, followed by multimodal treatments such as continued chemotherapy and RFA, led to the long-term survival.
authors.affiliation: Dept. of Surgery, Nishijin Hospital.
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Takagi
authors.forename: Yuen
authors.initials: Y
authors.lastname: Nakase
authors.forename: Kanehisa
authors.initials: K
authors.lastname: Fukumoto
authors.forename: Takuya
authors.initials: T
authors.lastname: Miyagaki
authors.forename: Eri
authors.initials: E
authors.lastname: Ishida
authors.forename: Yuka
authors.initials: Y
authors.lastname: Kobayashi
authors.forename: Kouichi
authors.initials: K
authors.lastname: Soga
authors.forename: Daisuke
authors.initials: D
authors.lastname: Kanemitsu
authors.forename: Kyouichi
authors.initials: K
authors.lastname: Kassai
authors.forename: Kyouko
authors.initials: K
authors.lastname: Sakamoto
authors.forename: Shinya
authors.initials: S
authors.lastname: Takenaka
authors.forename: Kunio
authors.initials: K
authors.lastname: Yanagida
authors.forename: Kenji
authors.initials: K
authors.lastname: Itani
authors.forename: Ikuko
authors.initials: I
authors.lastname: Fukumoto
mesh_terms: D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use; D017115:Catheter Ablation; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D004338:Drug Combinations; D005743:Gastrectomy; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary*; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D016609:Neoplasms, Second Primary / Q000556:secondary*; D010094:Oxonic Acid / Q000627:therapeutic use; D013274:Stomach Neoplasms / Q000473:pathology* / Q000628:therapy*; D005641:Tegafur / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D000964:Antimetabolites, Antineoplastic; D004338:Drug Combinations; C079198:S 1 (combination); D005641:Tegafur; D010094:Oxonic Acid