title: Advanced gastric cancer with liver and lymph node metastases successfully resected after induction chemotherapy with docetaxel, cisplatin and 5-fluorouracil.
abstract: BACKGROUND
  At diagnosis, about 35% of patients with gastric cancer present with distant metastases, and most patients with gastric cancer and liver metastases are excluded from curative surgery.
  
  
  METHODS
  We report a case of human epidermal growth factor receptor-2 (HER2)-negative gastric cancer with metastases to the liver and perigastric lymph nodes. The patient (a 60-year-old man) was considered unresectable at diagnosis and was treated with palliative chemotherapy (docetaxel plus cisplatin and 5-fluorouracil by continuous intravenous infusion over 5 days every 3 weeks). However, after 6 courses of chemotherapy, a computed tomography scan showed a reduction of the liver metastasis and the disappearance of the enlarged perigastric lymph nodes. The patient then underwent a curative gastrectomy, lymphadenectomy and liver resection. After surgery, the patient was treated with 6 courses of FOLFOX-4 regimen as adjuvant chemotherapy. With a follow-up of 26 months after surgery, the patient is alive and disease free.
  
  
  CONCLUSIONS
  In patients with metastatic gastric cancer, the prognosis is poor with a median overall survival of 11 months since curative treatments are excluded; however, this case illustrated that a personalized treatment with chemotherapy and surgery can allow a curative strategy in selected patients with HER2-negative advanced gastric cancer.
authors: Department of Oncology and Hematology, Ospedale Guglielmo Da Saliceto, Piacenza, Italy.
authors: Luigi
authors: L
authors: Cavanna
authors: Flavio Cesare
authors: FC
authors: Bodini
authors: Elisa Maria
authors: EM
authors: Stroppa
authors: Filippo
authors: F
authors: Banchini
authors: Emanuele
authors: E
authors: Michieletti
authors: Patrizio
authors: P
authors: Capelli
authors: Adriano
authors: A
authors: Zangrandi
authors: Elisa
authors: E
authors: Anselmi
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D002945:Cisplatin / Q000008:administration & dosage; D000077143:Docetaxel; D005472:Fluorouracil / Q000008:administration & dosage; D005743:Gastrectomy / Q000639:trends; D006801:Humans; D060828:Induction Chemotherapy / Q000379:methods*; D008113:Liver Neoplasms / Q000175:diagnosis / Q000188:drug therapy* / Q000556:secondary; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D013274:Stomach Neoplasms / Q000175:diagnosis / Q000188:drug therapy* / Q000601:surgery; D043823:Taxoids / Q000008:administration & dosage
chemical_list: D043823:Taxoids; D000077143:Docetaxel; D002945:Cisplatin; D005472:Fluorouracil