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新辅助放化疗联合腹腔镜远端胃癌根治术治疗进展期胃癌：1例病例报告并文献复习

Neoadjuvant chemoradiotherapy followed by laparoscopic distal gastrectomy in advanced gastric cancer: A case report and review of literature.

作者信息

Liu Zi-Ning, Wang Yin-Kui, Li Zi-Yu

机构信息

Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Gastrointestinal Cancer Center, Peking University Cancer Hospital & Institute, Beijing 100142, China.

出版信息

World J Clin Cases. 2021 Apr 16;9(11):2542-2554. doi: 10.12998/wjcc.v9.i11.2542.

DOI:10.12998/wjcc.v9.i11.2542
PMID:33889619
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8040168/
Abstract

BACKGROUND: The laparoscopic technique has been widely applied for early gastric cancer, with the advantages of minimal invasion and quick recovery. However, there is no report about the safety and oncological outcome of laparoscopic gastrectomy with D2 lymph node dissection for patients after neoadjuvant chemoradiotherapy. CASE SUMMARY: A 60-year-old man was diagnosed with advanced distal gastric cancer, cT4aN1M0 stage III. The neoadjuvant chemoradiotherapy was performed based on the regimen of gross tumor volume 50G y/25 f and clinical target volume 45 Gy/25 f, as well as concurrent S-1 60 mg Bid. Then laparoscopic distal gastrectomy with D2 lymph node dissection was undertaken successfully for him after achieving partial response evaluated by radiological examination. The patient recovered smoothly without moderate or severe postoperative complications. The postoperative pathological stage was ypT3N0M0 with American Joint Committee on Cancer tumor regression grade 1. He was still in good condition after 5 years of follow-up. CONCLUSION: Neoadjuvant chemoradiotherapy followed by laparoscopic technique could be applicable and may achieve satisfactory oncological outcomes. Our finding requires further validation by cohort studies.

摘要

背景：腹腔镜技术已广泛应用于早期胃癌，具有微创和恢复快的优点。然而，对于新辅助放化疗后的患者，腹腔镜D2淋巴结清扫胃切除术的安全性和肿瘤学结局尚无报道。 病例摘要：一名60岁男性被诊断为晚期远端胃癌，cT4aN1M0 III期。基于大体肿瘤体积50Gy/25次和临床靶体积45Gy/25次的方案以及同步S-1 60mg每日两次进行新辅助放化疗。在通过影像学检查评估达到部分缓解后，成功为他实施了腹腔镜远端胃切除术并进行D2淋巴结清扫。患者恢复顺利，无中度或重度术后并发症。术后病理分期为ypT3N0M0，美国癌症联合委员会肿瘤退缩分级为1级。随访5年后他仍状况良好。 结论：新辅助放化疗后采用腹腔镜技术是可行的，且可能取得满意的肿瘤学结局。我们的发现需要队列研究进一步验证。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/16af/8040168/49cad870c026/WJCC-9-2542-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/16af/8040168/aa0da8ee813a/WJCC-9-2542-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/16af/8040168/3cdb011c4f85/WJCC-9-2542-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/16af/8040168/9c9c84bbff41/WJCC-9-2542-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/16af/8040168/75d3c48dbae5/WJCC-9-2542-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/16af/8040168/49cad870c026/WJCC-9-2542-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/16af/8040168/aa0da8ee813a/WJCC-9-2542-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/16af/8040168/3cdb011c4f85/WJCC-9-2542-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/16af/8040168/9c9c84bbff41/WJCC-9-2542-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/16af/8040168/75d3c48dbae5/WJCC-9-2542-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/16af/8040168/49cad870c026/WJCC-9-2542-g005.jpg

相似文献

[1]
Neoadjuvant chemoradiotherapy followed by laparoscopic distal gastrectomy in advanced gastric cancer: A case report and review of literature.

World J Clin Cases. 2021-4-16

[2]
Neoadjuvant chemoradiotherapy followed by D2 gastrectomy in locally advanced gastric cancer.

World J Gastroenterol. 2015-3-7

[3]
[Neoadjuvant chemoradiotherapy combined with surgery versus direct surgery in the treatment of Siewert type II and III adenocarcinomas of the esophagogastric junction: long-term prognostic analysis of a prospective randomized controlled trial].

Zhonghua Wei Chang Wai Ke Za Zhi. 2021-2-25

[4]
[Clinical value of superior mesenteric vein (No.14v) lymph node dissection in D2 gastrectomy for locally advanced distal gastric cancer].

Zhonghua Wei Chang Wai Ke Za Zhi. 2018-10-25

[5]
[Safety and efficacy of adjuvant chemotherapy with oxaliplatin and S-1 for patients with locally advanced gastric cancer after D2 lymph nodes dissection].

Zhonghua Wei Chang Wai Ke Za Zhi. 2021-2-25

[6]
[Postoperative complications and their influence on the prognosis factors in gastric cancer patients receiving neoadjuvant treatment].

Zhonghua Wei Chang Wai Ke Za Zhi. 2021-2-25

[7]
[Feasibility analysis on membrane-based right-sided approach of laparoscopic suprapancreatic lymph node dissection for advanced distal gastric cancer].

Zhonghua Wei Chang Wai Ke Za Zhi. 2018-10-25

[8]
[Early postoperative complications and risk factors in laparoscopic D2 radical gastrectomy for gastric cancer].

Zhonghua Wei Chang Wai Ke Za Zhi. 2019-8-25

[9]
Robotic D2 Lymph Node Dissection During Distal Subtotal Gastrectomy for Gastric Cancer: Toward Procedural Standardization.

Ann Surg Oncol. 2016-8

[10]
Prospective randomized controlled trial to compare laparoscopic distal gastrectomy (D2 lymphadenectomy plus complete mesogastrium excision, D2 + CME) with conventional D2 lymphadenectomy for locally advanced gastric adenocarcinoma: study protocol for a randomized controlled trial.

Trials. 2018-8-9

本文引用的文献

[1]
Impact of postoperative infectious complications on adjuvant chemotherapy administration after gastrectomy for advanced gastric cancer.

Jpn J Clin Oncol. 2021-3-3

[2]
Neoadjuvant chemoradiotherapy for locally advanced gastric cancer with bulky lymph node metastasis: Five case reports.

World J Clin Cases. 2020-9-26

[3]
Using the Common Terminology Criteria for Adverse Events (CTCAE - Version 5.0) to Evaluate the Severity of Adverse Events of Anticancer Therapies.

Actas Dermosifiliogr (Engl Ed). 2021-1

[4]
Open vs. laparoscopic surgery for locally advanced gastric cancer after neoadjuvant therapy: Short-term and long-term survival outcomes.

Oncol Lett. 2020-7

[5]
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Surg Endosc. 2021-4

[6]
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World J Gastrointest Oncol. 2020-1-15

[7]
Phase II trial of preoperative sequential chemotherapy followed by chemoradiotherapy for high-risk gastric cancer.

Radiother Oncol. 2019-7-11

[8]
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BMC Cancer. 2019-6-20

[9]
Effect of Laparoscopic vs Open Distal Gastrectomy on 3-Year Disease-Free Survival in Patients With Locally Advanced Gastric Cancer: The CLASS-01 Randomized Clinical Trial.

JAMA. 2019-5-28

[10]
A CRITICal period for chemoradiotherapy in gastric cancer.

Lancet Oncol. 2018-5

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