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一例胃癌同步多发肝转移病例:术后长期无病生存

A case with synchronous multiple liver metastases from gastric carcinoma: postoperative long-term disease-free survival.

作者信息

Munekage Masaya, Okabayashi Takehiro, Hokimoto Norihiro, Sugimoto Takeki, Maeda Hiromichi, Namikawa Tsutomu, Dabanaka Ken, Kobayashi Michiya, Araki Keijiro, Hanazaki Kazuhiro

机构信息

Department of Surgery, Kochi Medical School, Kohasu-Okocho, Nankoku-City, Kochi, 783-8505, Japan.

出版信息

Langenbecks Arch Surg. 2009 Jul;394(4):749-53. doi: 10.1007/s00423-008-0434-z. Epub 2008 Nov 11.

Abstract

PURPOSE

We herein report a case with synchronous multiple liver metastases from gastric carcinoma surviving disease-free for more than 10 years after hepatic resection.

METHODS

A 64-year-old male admitted to our hospital because of constitutional wariness. Preoperative diagnosis was type 1 gastric cancer at the lower third of the stomach and multiple metastases of both hepatic lobes. After we performed distal gastrectomy with regional lymphadenectomy and wedge hepatic resection for eight metastatic liver tumors, he received 5-fluoropyrimidine and platinum-based adjuvant chemotherapy during the early postoperative period.

RESULTS

The pathologic examination revealed moderately differentiated gastric adenocarcinoma with regional lymph node metastasis and multiple liver metastases. The postoperative course was uneventful and the patient is doing well without disease recurrence after more than 10 years following surgery.

CONCLUSION

To the best of our knowledge, this patient is the longest disease-free survivor after liver resection for synchronous multiple liver metastases from advanced gastric cancer. In this modern era of developing liver surgery and adjuvant chemotherapy, combination therapy of aggressive surgery and early postoperative adjuvant chemotherapy for advanced gastric cancer with liver metastasis may allow long-term survival in selected patients.

摘要

目的

我们在此报告一例胃癌同步多发肝转移患者,肝切除术后无病生存超过10年。

方法

一名64岁男性因全身乏力入院。术前诊断为胃下部三分之一处的1型胃癌及两肝叶多发转移。我们对8个肝转移瘤进行了远端胃切除术及区域淋巴结清扫和楔形肝切除术后,他在术后早期接受了5-氟尿嘧啶和铂类辅助化疗。

结果

病理检查显示为中度分化胃腺癌伴区域淋巴结转移和多发肝转移。术后过程顺利,患者术后10多年来情况良好,无疾病复发。

结论

据我们所知,该患者是晚期胃癌同步多发肝转移肝切除术后无病生存时间最长的幸存者。在当今肝脏手术和辅助化疗不断发展的时代,对于晚期胃癌肝转移患者,积极手术与术后早期辅助化疗的联合治疗可能使部分患者获得长期生存。

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