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一例同步性进展期胃癌合并局部进展期前列腺癌的腹腔镜与机器人联合手术病例报告

A case of synchronous advanced gastric cancer and locally advanced prostate cancer with combined laparoscopic and robotic surgery: A case report.

作者信息

Imagami Toru, Takayama Satoru, Hattori Taku, Matsui Ryohei, Sakamoto Masaki, Kani Hisanori, Kurokawa Satoshi, Fujiwara Tsuyoshi

机构信息

Department of Surgery, Nagoya Tokushukai General Hospital, Kasugai City, Japan.

Department of Surgery, Nagoya Tokushukai General Hospital, Kasugai City, Japan.

出版信息

Int J Surg Case Rep. 2019;56:82-85. doi: 10.1016/j.ijscr.2019.02.032. Epub 2019 Mar 1.

Abstract

INTRODUCTION

The optimal management strategy for synchronous gastric cancer (GC) and prostate cancer (PCa) remains unclear, particularly in cases in which two cancers are progressive.

PRESENTATION OF CASE

A 68-year-old man diagnosed with synchronous advanced GC and locally advanced PCa was referred to our institution. Laparoscopic total gastrectomy (LTG) and robotic-assisted radical prostatectomy were simultaneously performed. The postoperative course was similar to the standard postoperative course of LTG alone. Pathological diagnoses were T3N3aM0 gastric adenocarcinoma and T3N0M0 prostatic adenocarcinoma. Adjuvant chemotherapy and adjuvant androgen deprivation therapy (ADT) for GC and PCa were initiated on postoperative days 15 and 27, respectively. Six months subsequent to surgery, the patient received adjuvant chemotherapy and ADT, and no evidence of cancer recurrence was observed.

DISCUSSION

In terms of survival, curative resection with adjuvant therapy is advantageous for patients with advanced GC or locally advanced PCa. At present, treatment for synchronous cancer should be combined with optimal management for individual cancers. Minimally invasive surgery may play an important role in the multidisciplinary treatment of synchronous advanced cancer.

CONCLUSION

Combined laparoscopic and robotic surgery for synchronous GC and PCa allows for minimally invasive radical resection and appropriate adjuvant therapy.

摘要

引言

同步性胃癌(GC)和前列腺癌(PCa)的最佳管理策略仍不明确,尤其是在两种癌症均进展的情况下。

病例介绍

一名68岁男性,被诊断为同步性晚期GC和局部晚期PCa,转诊至我院。同时进行了腹腔镜全胃切除术(LTG)和机器人辅助根治性前列腺切除术。术后病程与单纯LTG的标准术后病程相似。病理诊断为T3N3aM0胃腺癌和T3N0M0前列腺腺癌。分别在术后第15天和第27天开始对GC和PCa进行辅助化疗及辅助雄激素剥夺治疗(ADT)。术后6个月,患者接受辅助化疗和ADT,未观察到癌症复发迹象。

讨论

在生存方面,根治性切除联合辅助治疗对晚期GC或局部晚期PCa患者有利。目前,同步性癌症的治疗应结合对个体癌症的最佳管理。微创手术可能在同步性晚期癌症的多学科治疗中发挥重要作用。

结论

联合腹腔镜和机器人手术治疗同步性GC和PCa可实现微创根治性切除及适当的辅助治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2507/6409421/81074bae5453/gr1.jpg

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