[A Case of Alpha-Fetoprotein-Producing Gastric Cancer with Synchronous Liver Metastasis Achieving Recurrence-Free Survival for Five Years by Gastrectomy, Hepatectomy, and Adjuvant Chemotherapy].

a-fetoprotein(AFP)-producing gastric cancer is relatively rare and tends to show a poor prognosis because of hepatic and lymph node metastasis. We experienced a case of AFP-producing gastric cancer with synchronous liver metastasis wherein the patient survived for 5 years without recurrence after undergoing surgery and adjuvant chemotherapy. A 39-year-old woman was admitted to our hospital complaining of tarry stool. Upper gastrointestinal endoscopy revealed a 40mm type 2 tumor in the greater curvature of the lower gastric body, and abdominal CT indicated a 50mm liver metastasis at the S2 segment. The AFP serum level had risen to 71,000 ng/mL. We performed distal gastrectomy and hepatic left lateral segmentectomy. The primary gastric tumor and the hepatic metastasis were both positive for AFP by immunohistochemistry. After conducting 3 courses of S-1/CDDP(SP)therapy as adjuvant chemotherapy, the serum level of AFP had decreased to normal levels. Be- cause the level had risen to 116 ng/mL after a change to S-1 oral administration alone, we decided to re-start SP therapy and carried out 16 courses through the third postoperative year. The patient is still alive without recurrence 5 years after surgery.