title: Pathological complete response of synchronous multiple liver metastases associated with advanced gastric cancer to gastrectomy and prompt S-1 treatment in combination with fractional cisplatin: report of a case.
abstract: Systemic chemotherapy is the treatment recommended for prolonged survival in cases of metastatic gastric cancer. There have been a number of clinical reports of surgical resection of liver metastasis in selected patients with gastric cancer. Here, we report on a case of treatment of far advanced gastric cancer with synchronous multiple liver metastases with prompt S-1 in combination with fractional cisplatin sandwiched between twostage surgery. Metastases including peritoneal dissemination and extensive lymph node involvement were absent so it was feasible to completely remove all of the macroscopic liver metastases. Each step of the chemotherapy progressed satisfactorily and histological examination after the hepatectomy yielded a pathologically complete response of liver metastases from the gastric cancer. This strategy provides a promising treatment for far advanced gastric cancer with a limited number of synchronous liver metastases. The referral to surgical oncology is a crucial step for the documentation of pathological complete response.
authors.affiliation: Department of Gastrointestinal Surgery, University of Tokyo, Tokyo, Japan. souya.nunobe@jfcr.or.jp
authors.forename: Souya
authors.initials: S
authors.lastname: Nunobe
authors.forename: Takashi
authors.initials: T
authors.lastname: Kiyokawa
authors.forename: Fumihiko
authors.initials: F
authors.lastname: Hatao
authors.forename: Ikuo
authors.initials: I
authors.lastname: Wada
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Shimizu
authors.forename: Sachiyo
authors.initials: S
authors.lastname: Nomura
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Mise
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Sugawara
authors.forename: Norihiro
authors.initials: N
authors.lastname: Kokudo
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Seto
mesh_terms: D000230:Adenocarcinoma / Q000556:secondary* / Q000628:therapy*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant; D002945:Cisplatin / Q000008:administration & dosage; D004338:Drug Combinations; D005743:Gastrectomy; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary* / Q000628:therapy*; D008297:Male; D059146:Metastasectomy; D008875:Middle Aged; D010094:Oxonic Acid / Q000008:administration & dosage; D013274:Stomach Neoplasms / Q000473:pathology* / Q000628:therapy*; D005641:Tegafur / Q000008:administration & dosage; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D004338:Drug Combinations; C079198:S 1 (combination); D005641:Tegafur; D010094:Oxonic Acid; D002945:Cisplatin