Journal of Gastric Cancer

The Korean Gastric Cancer Association (대한위암학회)
권호 표지
DOI QR코드

DOI QR Code

Long-term Survival after Repeated Local Therapy and Salvage Chemotherapy for Recurrent Metastases from Gastric Cancer: a Case Report and Literature Review

  • Kwon, Jihyun (Department of Internal Medicine, Chungbuk National University Hospital) ;
  • Han, Hye Sook (Department of Internal Medicine, Chungbuk National University Hospital) ;
  • Kim, Hee Kyung (Department of Internal Medicine, Chungbuk National University Hospital) ;
  • Baek, Seung-Woo (Department of Internal Medicine, Chungbuk National University Hospital) ;
  • Yang, Yaewon (Department of Internal Medicine, Chungbuk National University Hospital) ;
  • Lee, Ki Hyeong (Department of Internal Medicine, Chungbuk National University Hospital) ;
  • Son, Seung-Myoung (Department of Pathology, Chungbuk National University Hospital) ;
  • Kim, Won-Dong (Department of Radiation Oncology, Chungbuk National University Hospital) ;
  • Kim, Dae Hoon (Department of Surgery, Chungbuk National University Hospital) ;
  • Yun, Hyo Yung (Department of Surgery, Chungbuk National University Hospital)
  • Received : 2018.07.05
  • Accepted : 2018.08.14
  • Published : 2018.09.30
Download PDF
⟨ Previous Next ⟩

Abstract

We report a rare case of long-term survival in a patient who received local therapy and salvage chemotherapy for recurrent metastases, along with a literature review. A 65-year-old male patient underwent subtotal gastrectomy for advanced gastric adenocarcinoma. Six months after gastrectomy, 2 metastatic intra-abdominal lymph node enlargements were detected, which were treated with radiotherapy. At 55 months after gastrectomy, an abdominal wall mass was detected, which was treated by surgical resection. The patient received 5-fluorouracil/leucovorin/irinotecan chemotherapy for 27 months before and after radiotherapy and docetaxel chemotherapy for 6 months after surgical resection of the abdominal wall metastasis. At the last visit, 7.8 years since the initial resection of the primary gastric cancer and 6.2 years since detection of the first metastases, the patient was disease-free and required no further chemotherapy. This case suggests that repeated local therapy offers potential for long-term survival in a carefully selected subset of patients with recurrent metastases.

Keywords

References

  1. Lee JH, Kim JG, Jung HK, Kim JH, Jeong WK, Jeon TJ, et al. Clinical practice guidelines for gastric cancer in Korea: an evidence-based approach. J Gastric Cancer 2014;14:87-104. https://doi.org/10.5230/jgc.2014.14.2.87
  2. Bang YJ, Van Cutsem E, Feyereislova A, Chung HC, Shen L, Sawaki A, et al. Trastuzumab in combination with chemotherapy versus chemotherapy alone for treatment of HER2-positive advanced gastric or gastro-oesophageal junction cancer (ToGA): a phase 3, open-label, randomised controlled trial. Lancet 2010;376:687-697. https://doi.org/10.1016/S0140-6736(10)61121-X
  3. Tanai C, Hamaguchi T, Watanabe S, Katai H, Tochigi N, Shimada Y. A case of long-term survival after surgical resection of solitary pulmonary metastasis from gastric cancer. Jpn J Clin Oncol 2010;40:85-89. https://doi.org/10.1093/jjco/hyp098
  4. Fumagalli U, de Carli S, de Pascale S, Rimassa L, Bignardi M, Rosati R. Adrenal metastases from adenocarcinoma of the esophagogastric junction: adrenalectomy and long-term survival. Updates Surg 2010;62:63-67. https://doi.org/10.1007/s13304-010-0012-0
  5. Choi YJ, Kim DH, Han HS, Han JH, Son SM, Kim DS, et al. Long-term survival after gastrectomy and metastasectomy for gastric cancer with synchronous bone metastasis. World J Gastroenterol 2018;24:150-156. https://doi.org/10.3748/wjg.v24.i1.150
  6. Takemura N, Saiura A, Koga R, Arita J, Yoshioka R, Ono Y, et al. Long-term outcomes after surgical resection for gastric cancer liver metastasis: an analysis of 64 macroscopically complete resections. Langenbecks Arch Surg 2012;397:951-957. https://doi.org/10.1007/s00423-012-0959-z
  7. Kodera Y, Fujitani K, Fukushima N, Ito S, Muro K, Ohashi N, et al. Surgical resection of hepatic metastasis from gastric cancer: a review and new recommendation in the Japanese gastric cancer treatment guidelines. Gastric Cancer 2014;17:206-212. https://doi.org/10.1007/s10120-013-0299-x
  8. Guner A, Son T, Cho I, Kwon IG, An JY, Kim HI, et al. Liver-directed treatments for liver metastasis from gastric adenocarcinoma: comparison between liver resection and radiofrequency ablation. Gastric Cancer 2016;19:951-960. https://doi.org/10.1007/s10120-015-0522-z
  9. Markar SR, Mikhail S, Malietzis G, Athanasiou T, Mariette C, Sasako M, et al. Influence of surgical resection of hepatic metastases from gastric adenocarcinoma on long-term survival: systematic review and pooled analysis. Ann Surg 2016;263:1092-1101. https://doi.org/10.1097/SLA.0000000000001542
  10. Baek HU, Kim SB, Cho EH, Jin SH, Yu HJ, Lee JI, et al. Hepatic resection for hepatic metastases from gastric adenocarcinoma. J Gastric Cancer 2013;13:86-92. https://doi.org/10.5230/jgc.2013.13.2.86
  11. Benson AB 3rd, Venook AP, Al-Hawary MM, Cederquist L, Chen YJ, Ciombor KK, et al. NCCN guidelines insights: colon cancer, version 2.2018. J Natl Compr Canc Netw 2018;16:359-369. https://doi.org/10.6004/jnccn.2018.0021
  12. Bellier J, De Wolf J, Hebbar M, Amrani ME, Desauw C, Leteurtre E, et al. Repeated resections of hepatic and pulmonary metastases from colorectal cancer provide long-term survival. World J Surg 2018;42:1171-1179. https://doi.org/10.1007/s00268-017-4265-3
  13. Salah S, Watanabe K, Park JS, Addasi A, Park JW, Zabaleta J, et al. Repeated resection of colorectal cancer pulmonary oligometastases: pooled analysis and prognostic assessment. Ann Surg Oncol 2013;20:1955-1961. https://doi.org/10.1245/s10434-012-2860-y
  14. Nakahashi C, Kinoshita T, Konishi M, Nakagohri T, Inoue K, Oda T, et al. Long-term survival achieved by repeated resections of metachronous pulmonary and adrenal metastases of alpha-fetoprotein-producing gastric cancer: report of a case. Surg Today 2004;34:784-787.
  15. Mokuno Y, Katayama M, Ogura Y, Kimura K, Koh K. Long-term survival after resection of metachronous bilateral adrenal metastases of mucinous gastric carcinoma: report of a case. Surg Today 2006;36:554-558. https://doi.org/10.1007/s00595-006-3180-2
  16. Kojima H, Isaka M, Takahashi S, Machida N, Funai K, Ohde Y. Long-term survival after pulmonary resections for multiple metastases from gastric cancer: A case report. Int J Surg Case Rep 2018;45:87-90. https://doi.org/10.1016/j.ijscr.2018.03.020