Hama Naoki, Kashiwazaki Masaki, Ebisui Chikara, Okubo Keita, Akitake Hironori, Ohtsuka Masahisa, Yamanaka Chihiro, Maekawa Takayo, Yoshioka Shinichi, Taniguchi Masaaki, Tsujie Masaki, Konishi Muneharu, Fujimoto Takayoshi
Department of Surgery, Hyogo Prefectural Nishinomiya Hospital.
Gan To Kagaku Ryoho. 2009 Nov;36(12):2330-2.
The patient was a 75-year-old man, who was diagnosed with type 3 gastric cancer with solitary liver metastasis whose diameter was 12 mm. Distal gastrectomy with D2 lymph node dissection was performed in June 2008. S-1 monotherapy (120 mg/day, day 1-28/42 days) for liver metastasis started as the first-line chemotherapy. After 3 courses, the diameter of liver metastasis enlarged to 22 mm. Moreover, S-1 and CDDP combined chemotherapy (S-1: 120 mg/day, day 1-21/ 35 days, CDDP: 60 mg/m2, day 8/35 days) was performed as the second-line chemotherapy, nevertheless the diameter of liver metastasis enlarged to 26 mm. No distant metastasis without solitary liver tumor was observed for 6 months after gastric resection, so a partial hepatic resection was performed in February 2009. Five months after the operation, the patient is doing well and shows no signs of recurrence of the cancer. A combination gastrectomy with D2 lymphadenectomy and postoperative chemotherapy was considered to be a radical treatment for H1, Stage IV gastric cancer.
该患者为一名75岁男性,被诊断为伴有直径12mm孤立性肝转移的3型胃癌。2008年6月进行了远端胃切除术及D2淋巴结清扫术。作为一线化疗,开始使用S-1单药治疗(120mg/天,第1 - 28天/每42天为一周期)治疗肝转移。3个疗程后,肝转移灶直径增大至22mm。此外,作为二线化疗,进行了S-1与顺铂联合化疗(S-1:120mg/天,第1 - 21天/每35天为一周期,顺铂:60mg/m²,第8天/每35天为一周期),然而肝转移灶直径增大至26mm。胃切除术后6个月未观察到无孤立性肝肿瘤的远处转移,因此于2009年2月进行了部分肝切除术。术后5个月,患者情况良好,未显示出癌症复发迹象。联合胃切除术加D2淋巴结清扫术及术后化疗被认为是H1期IV型胃癌的根治性治疗方法。