title: [A case of AFP-producing gastric cancer with peritoneal metastasis treated effectively with chemotherapy, mainly using S-1 and trastuzumab].
abstract: A 71-year-old man, diagnosed with advanced gastric cancer and severe pyloric stenosis, was introducted to our hospital. Para-aortic lymph nodes metastasis and pancreas invasion were seen with enhanced CT scan. Serum AFP showed a high price (1,465.3 ng/mL). Because significant peritoneal metastases were seen in the abdominal cavity, gastrojejunostomy was performed. Overexpression of the HER2 gene was seen by immunostaining for peritoneal dissemination of the omentum. After starting S-1 + CDDP + trastuzumab, the AFP was normalized immediately (7. 6 ng/mL). We then performed colostomy for a sigmoid colon stenosis. S-1 + DOC + trastuzumab was administered afterward, and we performed closure of the colostomy because the stenosis was improved. Macroscopic peritoneal dissemination in the abdomen disappeared. AFP-producing gastric cancer with peritoneal metastasis has a poor prognosis, but chemotherapy, mainly with S-1 and trastuzumab, was effective for it.
authors.affiliation: Dept. of Surgery, Nara Prefectural Nara Hospital.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Nishiwada
authors.forename: Akihiko
authors.initials: A
authors.lastname: Watanabe
authors.forename: Takahiro
authors.initials: T
authors.lastname: Yoshikawa
authors.forename: Kohei
authors.initials: K
authors.lastname: Ishioka
authors.forename: Tomohide
authors.initials: T
authors.lastname: Mukogawa
authors.forename: Masanori
authors.initials: M
authors.lastname: Matsusaka
authors.forename: Saiho
authors.initials: S
authors.lastname: Ko
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Ishikawa
mesh_terms: D000368:Aged; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage; D000970:Antineoplastic Agents / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D004338:Drug Combinations; D006801:Humans; D008297:Male; D010094:Oxonic Acid / Q000008:administration & dosage; D010534:Peritoneal Neoplasms / Q000556:secondary*; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology*; D005641:Tegafur / Q000008:administration & dosage; D000068878:Trastuzumab; D000509:alpha-Fetoproteins / Q000096:biosynthesis*
chemical_list: C097353:AFP protein, human; D061067:Antibodies, Monoclonal, Humanized; D000964:Antimetabolites, Antineoplastic; D000970:Antineoplastic Agents; D004338:Drug Combinations; D000509:alpha-Fetoproteins; C079198:S 1 (combination); D005641:Tegafur; D010094:Oxonic Acid; D000068878:Trastuzumab