title: [Pre-Operative Treatment with Transcatheter Arterial Chemoembolization (TACE) and Hepatic Arterial Infusion (HAI) for Liver Metastasis from Gastric Cancer--A Case Report].
abstract: The patient was an 83-year-old man who underwent distal gastrectomy for gastric cancer (T3, N1, M0, P0, M0, stage ⅡB) at a different hospital from ours. A metastatic lesion was detected in the liver 5 months after gastrectomy. Although chemotherapy with S-1 or bi-weekly CPT-11 was administered for 6 months, the liver tumor increased in size. The patient was referred to our hospital for treatment of the liver metastasis. Abdominal-computed tomography (CT) and magnetic resonance imaging (MRI) revealed a solitary metastatic liver tumor (9 cm in diameter: S7/S6/S8) with a hypervascular tumor stain. Transcatheter arterial chemoembolization (TACE) using degradable starch microspheres (DSM) plus mitomycin C, and hepatic arterial infusion (HAI) using high-dose 5-fluorouracil (5-FU) (6,000 mg/week), were performed 54 days before curative resection of the liver (S6+S7+S8+S5b/c). Histological findings revealed metastatic adenocarcinoma with a tumor thrombus in the posterior branch of the portal vein. The patient was treated with 2 courses of adjuvant chemotherapy with paclitaxel. No recurrence was observed 8 months after hepatectomy. This case suggests that combined treatment with TACE/HAI as a multimodal treatment might be effective in the management of hypervascular liver metastasis from gastric cancer.
authors.affiliation: Dept. of Gastroenterological Surgery, Iseikai Hospital.
authors.forename: Takahiko
authors.initials: T
authors.lastname: Tanigawa
authors.forename: Yasunori
authors.initials: Y
authors.lastname: Hasuike
authors.forename: Yousuke
authors.initials: Y
authors.lastname: Akiyama
authors.forename: Ichiro
authors.initials: I
authors.lastname: Higuchi
authors.forename: Akira
authors.initials: A
authors.lastname: Ishikawa
authors.forename: Atsuya
authors.initials: A
authors.lastname: Okada
authors.forename: Makoto
authors.initials: M
authors.lastname: Miyamoto
mesh_terms: D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002166:Camptothecin / Q000008:administration & dosage / Q000031:analogs & derivatives; D016461:Chemoembolization, Therapeutic; D003131:Combined Modality Therapy; D005472:Fluorouracil / Q000008:administration & dosage; D005743:Gastrectomy; D006498:Hepatectomy; D006801:Humans; D007261:Infusions, Intra-Arterial; D000077146:Irinotecan; D008113:Liver Neoplasms / Q000556:secondary / Q000628:therapy*; D008297:Male; D013274:Stomach Neoplasms / Q000473:pathology* / Q000628:therapy
chemical_list: D000077146:Irinotecan; D005472:Fluorouracil; D002166:Camptothecin