Chuman Motohiro, Takahashi Yoshihito, Tokito Takaaki, Maruyama Masahiro, Chino Shinichiro, Ushiku Hideki, Nakamura Kazunori, Naito Masanori, Kondo Yasushi, Yamazaki Hitoshi, Nishi Yatsushi, Hiki Naoki
Dept. of Surgery, Kitasato University Medical Center.
Gan To Kagaku Ryoho. 2020 Dec;47(13):2065-2067.
We report a case of laparoscopic partial hepatectomy after nab-paclitaxel plus ramucirumab(nab-PTX plus RAM)combination therapy for postoperative liver recurrence of gastric cancer. The patient was a 50's man who underwent laparoscopic distal gastrectomy, D2 lymph node dissection, and Billroth-I reconstruction for gastric cancer. The pathological findings were L, Gre, Post, Type 3, por>tub2, pT3N3a, M1(CY1), fStage Ⅳ. Postoperative chemotherapy with S-1 was performed. The CT examination 6 months after the operation revealed a total of 3 tumors(maximum diameter of 5×4 cm)in liver segments S6, 7, and 8. We started nab-PTX plus RAM combination therapy for liver metastases and performed laparoscopic partial hepatectomy when 12 courses of the treatment were completed. The postoperative course was uneventful, and the patient was discharged on postoperative day 7. Pathological results suggested that the tumor was exposed on the cut surface, and 6 courses of nab-PTX plus RAM combination therapy were administered postoperatively. The patient has been recurrence-free 12 months after the operation.
我们报告了1例接受纳武单抗联合雷莫西尤单抗（nab - 紫杉醇联合雷莫西尤单抗）治疗胃癌术后肝转移后行腹腔镜下肝部分切除术的病例。患者为50多岁男性，因胃癌接受了腹腔镜远端胃切除术、D2淋巴结清扫术及毕Ⅰ式重建术。病理结果为L、Gre、Post、3型，管状>乳头状2型，pT3N3a，M1（CY1），fStageⅣ期。术后给予S - 1辅助化疗。术后6个月的CT检查显示肝S6、S7和S8段共有3个肿瘤（最大直径5×4 cm）。我们开始对肝转移灶进行纳武单抗联合雷莫西尤单抗治疗，在完成12个疗程治疗后行腹腔镜下肝部分切除术。术后恢复顺利，患者于术后第7天出院。病理结果显示肿瘤在切面上暴露，术后又给予6个疗程的纳武单抗联合雷莫西尤单抗治疗。患者术后12个月无复发。
