[A case of Stage IV gastric cancer was successfully treated with multi combination chemotherapy with S-1].
Stage IV gastric cancer has poor prognosis, and median survival time (MST) is reported to range from 6 to 13 months. We report a case of long-term survival in a Stage IV gastric cancer patient who was successfully treated with multi combination chemotherapy with S-1. A 73-year-old woman presenting with gastric cancer with pyloric stenosis and peritoneal dissemination at the sigmoid colon underwent distal gastrectomy with D2 lymphadenectomy and sigmoidectomy. She received adjuvant chemotherapy with S-1 and CDDP after surgery. During the twelfth administration of S-1 and CDDP, she developed an anaphylactic reaction against CDDP; therefore, only S-1 was administered for the next 6 courses. Thirty one months postgastrectomy, a left ovarian metastasis (about 4 cm) was detected by computed tomography. Two courses of S-1 and CPT-11 were administered; however, the ovarian metastasis grew to twice its initial size. She underwent hysterectomy and bilateral ovariectomy. The pathological diagnosis was metastatic tumors in the uterus and ovary(Krukenberg tumor). After the second surgery, S-1 and docetaxel therapy was initiated. A metastasis (S2, 5mm diameter) appeared in the right lung around 65 months after the gastrectomy. The patient received a total of 28 courses, up until 69 months post-gastrectomy. At present, she hopes to finish the chemotherapy and is consulting a palliative care facility. At 80 months post-gastrectomy, she has no symptoms because the lung metastasis exhibits slow growth (15 mm diameter), and is maintaining her quality of life (QOL).
Dept. of Surgery, Tokyo Metropolitan Toshima Hospital.
Katsunori
K
Ami
Kentarou
K
Gokita
Yousuke
Y
Kawai
Yutarou
Y
Matsunaga
Keiichi
K
Fujiya
Nana
N
Ohshima
Hidetoshi
H
Amagasa
Hideaki
H
Ganno
Kenichirou
K
Imai
Akira
A
Fukuda
Takeshi
T
Nagahama
Masayuki
M
Ando
Youichi
Y
Okada
Hidetaka
H
Akita
Shikofumi
S
Tei
Yousuke
Y
Yamada
Mariko
M
Takagi
Fumi
F
Kodaka
Kuniyoshi
K
Arai
D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D004338:Drug Combinations; D005260:Female; D005743:Gastrectomy; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy / Q000556:secondary; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000188:drug therapy / Q000556:secondary; D010094:Oxonic Acid / Q000008:administration & dosage*; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D005641:Tegafur / Q000008:administration & dosage*
D004338:Drug Combinations; C079198:S 1 (combination); D005641:Tegafur; D010094:Oxonic Acid