Konno H, Ida K, Sakaguchi S, Aoki K, Baba S, Ihara M
Second Department of Surgery, Hamamatsu University School of Medicine, Japan.
Jpn J Surg. 1991 Sep;21(5):556-60. doi: 10.1007/BF02470994.
A case of advanced gastric cancer associated with acute myelocytic leukemia (AML) is reported. Synchronous double malignancies of gastric cancer and AML are very rare. Combination chemotherapy (BHAC-DMP) was used as the method for induction and consolidation therapy for AML and a complete remission was obtained. However, it failed to show any therapeutic effect on the gastric cancer. A radical subtotal gastrectomy was performed with lymphadenectomy. During the postoperative course, both respiratory failure and severe thrombocytopenia progressed. Fortunately, the patient responded well to mechanical ventilation and the administration of heparin. She was discharged on day 52 after surgery, and no sign of recurrence of either gastric cancer or AML has been observed over the one-year period following the gastrectomy. In principle, in order to achieve a good prognosis, a radical resection should be carried out for gastric cancer associated with AML. However, chemotherapy for AML might make the patient vulnerable to surgical stress, although we could not demonstrate any concrete evidence which could prove the impairment of host immunity in this case. It is, therefore, possible that not only the relapse of AML but also the impairment of host immunity may cause some other difficulties during the post-gastrectomy course.
报告了一例晚期胃癌合并急性髓细胞白血病（AML）的病例。胃癌和AML的同步双原发恶性肿瘤非常罕见。联合化疗（BHAC-DMP）被用作AML的诱导和巩固治疗方法，并获得了完全缓解。然而，它对胃癌没有显示出任何治疗效果。进行了根治性胃大部切除术并清扫淋巴结。术后过程中，呼吸衰竭和严重血小板减少症进展。幸运的是，患者对机械通气和肝素治疗反应良好。她在术后第52天出院，胃切除术后一年期间未观察到胃癌或AML复发的迹象。原则上，为了获得良好的预后，对于合并AML的胃癌应进行根治性切除。然而，AML的化疗可能会使患者更容易受到手术应激的影响，尽管我们在该病例中未能证明任何能够证实宿主免疫受损的具体证据。因此，不仅AML的复发，而且宿主免疫的损害都有可能在胃切除术后过程中引起一些其他困难。
