title: Successful treatment of advanced gastric adenocarcinoma with portal tumor thrombosis by total gastrectomy following CDDP and S-1 therapy.
abstract: Gastric cancers with portal tumor thrombosis (GCPTs) are a rare entity, often concomitant with hematogenous metastases, and chemotherapy is mainly used to treat them. However, the outcome of GCPT is reported to be dismal. We experienced a case of GCPT with splenic metastases. A 53-year-old man was admitted for anorexia. Upper gastrointestinal scope revealed type 3 gastric cancer of the stomach. Abdominal computed tomography showed a huge tumor thrombus in the splenic vein extending to the hepatic hilus and multiple metastases to the spleen. S-1 was given orally from day 1 to day 21 and 60 mg of CDDP was administered intravenously. The cancerous thrombosis in the portal system and splenic metastases disappeared due to chemotherapy. Total gastrectomy with lymphadenectomy and splenectomy was carried out with curative intent after 10 courses of chemotherapy. Intraoperatively, no tumor thrombosis was identified and the gastric tumor was surgically removed. After surgery, the patient received adjuvant chemotherapy of S-1. After 6 months he is well and has not suffered from tumor relapse. A combination of CDDP + S-1 plus intervention surgery seems to be a promising option for GCPT.
authors.affiliation: Department of Digestive Surgery, and Breast and Thyroid Surgery, Kagoshima University School of Medicine, 8-35-1 Sakuragaoka, Kagoshima, 890-8520, Japan. ishiga@m.kufm.kagoshima-u.ac.jp.
authors.forename: Sumiya
authors.initials: S
authors.lastname: Ishigami
authors.affiliation: Department of Digestive Surgery, and Breast and Thyroid Surgery, Kagoshima University School of Medicine, 8-35-1 Sakuragaoka, Kagoshima, 890-8520, Japan.
authors.forename: Takaaki
authors.initials: T
authors.lastname: Arigami
authors.affiliation: Department of Digestive Surgery, and Breast and Thyroid Surgery, Kagoshima University School of Medicine, 8-35-1 Sakuragaoka, Kagoshima, 890-8520, Japan.
authors.forename: Keishi
authors.initials: K
authors.lastname: Okubo
authors.affiliation: Department of Digestive Surgery, and Breast and Thyroid Surgery, Kagoshima University School of Medicine, 8-35-1 Sakuragaoka, Kagoshima, 890-8520, Japan.
authors.forename: Ken
authors.initials: K
authors.lastname: Sasaki
authors.affiliation: Department of Digestive Surgery, and Breast and Thyroid Surgery, Kagoshima University School of Medicine, 8-35-1 Sakuragaoka, Kagoshima, 890-8520, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kurahara
authors.affiliation: Department of Digestive Surgery, and Breast and Thyroid Surgery, Kagoshima University School of Medicine, 8-35-1 Sakuragaoka, Kagoshima, 890-8520, Japan.
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Uenosono
authors.affiliation: Department of Digestive Surgery, and Breast and Thyroid Surgery, Kagoshima University School of Medicine, 8-35-1 Sakuragaoka, Kagoshima, 890-8520, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Okumura
authors.affiliation: Department of Digestive Surgery, and Breast and Thyroid Surgery, Kagoshima University School of Medicine, 8-35-1 Sakuragaoka, Kagoshima, 890-8520, Japan.
authors.forename: Tetsuhiro
authors.initials: T
authors.lastname: Owaki
authors.affiliation: Department of Digestive Surgery, and Breast and Thyroid Surgery, Kagoshima University School of Medicine, 8-35-1 Sakuragaoka, Kagoshima, 890-8520, Japan.
authors.forename: Yuko
authors.initials: Y
authors.lastname: Kijima
authors.affiliation: Department of Digestive Surgery, and Breast and Thyroid Surgery, Kagoshima University School of Medicine, 8-35-1 Sakuragaoka, Kagoshima, 890-8520, Japan.
authors.forename: Shinichi
authors.initials: S
authors.lastname: Ueno
authors.affiliation: Department of Digestive Surgery, and Breast and Thyroid Surgery, Kagoshima University School of Medicine, 8-35-1 Sakuragaoka, Kagoshima, 890-8520, Japan.
authors.forename: Shoji
authors.initials: S
authors.lastname: Natsugoe
keywords: Chemotherapy; Gastrectomy; Gastric cancer; Portal tumor thrombosis; Splenic metastasis