[Complete resection of advanced gastric cancer with multiple liver metastases following a bypass operation and one year of chemotherapy].

We report a case of advanced gastric cancer with multiple liver metastases,in which a complete resection was performed following a bypass operation and chemotherapy. A 55-year-old man presented with vomiting and body weight loss. Gastrointestinal endoscopy revealed advanced gastric cancer with pyloric stenosis, and abdominal computed tomography showed multiple liver metastases in segments 2, 3, 5, and 6. A gastrojejunostomy was performed on August 24, 2004. The patient was then treated with 3 cycles of S-1 (120 mg/body, days 1-21) plus cisplatin (80 mg/body,day 8),followed by 8 cycles of weekly paclitaxel (wPTX; 140 mg/body, days 1,8, and 15). The primary tumor and liver tumors remained stable following the 3 cycles of S-1 plus cisplatin, but the liver tumors were considerably smaller after 3 cycles of wPTX. On August 25, 2005, a distal gastrectomy with D2 lymphadenectomy,lateral segmentectomy,and S5 partial hepatectomy was performed. The surgery was completed with no residual macroscopic or microscopic tumors. The patient received 6 cycles of wPTX as adjuvant therapy,and remained well with no evidence of tumor recurrence 28 months after the initial treatment.