title: [Surgical Resection for a Metachronous Liver Metastasis of an Esophagogastric Junction Adenocarcinoma].
abstract: The patient was a 56-year-old man with advanced esophagogastric junction cancer. He received neoadjuvant chemotherapy with 5-FU plus CDDP followed by lower esophagectomy and total gastrectomy via the left thoracoabdominal approach in October 2011. Pathological examination revealed EGJ adenocarcinoma (ypT4aN1M0, Stage ⅢA, Japanese Classification of Gastric Carcinoma ver.14), and histological analysis indicated Grade 0 (no change). Adjuvant chemotherapy with S-1 was administered. Nevertheless, 6 months after the operation, a solitary hepatic metastasis (f: 32 mm) was detected in S7 of the liver. The patient underwent proton beam irradiation of the liver metastasis, resulting in a complete response, and he was followed up without any chemotherapy. However, 21 months after the irradiation, regrowth of the previous lesion with FDG re-accumulation was noted. Given the absence of any neoplasms other than the liver metastasis, right hepatic lobectomy was performed. Pathological examination revealed a small cluster of viable tumor cells surrounded by extensive fibrotic tissue (Grade 2). At 45 months after the initial operation (10 months after the liver lobectomy), the patient is living without any signs of recurrence. Surgical resection for liver metastasis of EGJ cancer may be feasible after careful selection.
authors.affiliation: Dept. of Regenerative Surgery, Fukushima Medical Universitye.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Tada
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Kikuchi
authors.forename: Junichiro
authors.initials: J
authors.lastname: Watanabe
authors.forename: Naoya
authors.initials: N
authors.lastname: Sato
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Hanayama
authors.forename: Hisahito
authors.initials: H
authors.lastname: Endo
authors.forename: Takayuki
authors.initials: T
authors.lastname: Anazawa
authors.forename: Zenichiro
authors.initials: Z
authors.lastname: Saze
authors.forename: Takashi
authors.initials: T
authors.lastname: Kimura
authors.forename: Fumihiko
authors.initials: F
authors.lastname: Osuka
authors.forename: Akira
authors.initials: A
authors.lastname: Kenjo
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kawana
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Tasaki
authors.forename: Yuko
authors.initials: Y
authors.lastname: Hashimoto
authors.forename: Mitsukazu
authors.initials: M
authors.lastname: Gotoh
mesh_terms: D000230:Adenocarcinoma / Q000556:secondary / Q000628:therapy*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D003131:Combined Modality Therapy; D004938:Esophageal Neoplasms / Q000556:secondary / Q000628:therapy*; D016629:Esophagectomy; D004943:Esophagogastric Junction / Q000473:pathology* / Q000601:surgery; D005743:Gastrectomy; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary / Q000628:therapy*; D008297:Male; D008875:Middle Aged