TY - JOUR
T1 - Successful treatment of advanced gastric adenocarcinoma with portal tumor thrombosis by total gastrectomy following CDDP and S-1 therapy
AU - Ishigami, Sumiya
AU - Arigami, Takaaki
AU - Okubo, Keishi
AU - Sasaki, Ken
AU - Kurahara, Hiroshi
AU - Uenosono, Yoshikazu
AU - Okumura, Hiroshi
AU - Owaki, Tetsuhiro
AU - Kijima, Yuko
AU - Ueno, Shinichi
AU - Natsugoe, Shoji
PY - 2012/6
Y1 - 2012/6
N2 - 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.
AB - 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.
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U2 - 10.1007/s12328-012-0307-4
DO - 10.1007/s12328-012-0307-4
M3 - Article
AN - SCOPUS:84863728821
SN - 1865-7257
VL - 5
SP - 230
EP - 233
JO - Clinical Journal of Gastroenterology
JF - Clinical Journal of Gastroenterology
IS - 3
ER -