NHS Tayside, UK.
University of Dundee, UK.
Ann R Coll Surg Engl. 2022 Jul;104(7):e197-e201. doi: 10.1308/rcsann.2021.0235. Epub 2021 Nov 30.
Perioperative oncological therapies resulting in pathological complete response (pCR) in diffuse-type distal gastric adenocarcinoma are extremely rare. We report a case of locally advanced (cT3 N2 M0) diffuse-type distal gastric adenocarcinoma treated with 'total neoadjuvant' FLOT (eight cycles), due to the COVID-19 pandemic, and laparoscopic radical subtotal gastrectomy with D2 lymphadenectomy. The patient demonstrated a progressive radiological response on positron emission tomography with 2-deoxy-2-[fluorine-18]fluoro-d-glucose integrated with computed tomography (F-FDG PET-CT) and pCR in the resected specimen (ypT0 N0). As far as we are aware, this is the first case of pCR in locally advanced T3 N2 diffuse distal gastric cancer to be reported in the literature. It introduces a novel approach of total neoadjuvant chemotherapy with F-FDG PET-CT to assess response, combined with radical minimally invasive surgical management to provide optimal care for patients with gastric cancer.
弥漫型远端胃癌患者在围手术期接受肿瘤治疗后出现病理完全缓解（pCR）的情况极为罕见。由于 COVID-19 大流行，我们报告了一例局部晚期（cT3 N2 M0）弥漫型远端胃癌患者接受了“全新辅助”FLOT（8 个周期）治疗，然后行腹腔镜根治性胃大部切除术加 D2 淋巴结清扫术。该患者在正电子发射断层扫描与计算机断层扫描融合的 2-脱氧-2-[氟-18]氟代-d-葡萄糖（F-FDG PET-CT）上显示出进行性放射学反应，且在切除标本中达到 pCR（ypT0 N0）。据我们所知，这是首例在局部晚期 T3 N2 弥漫型远端胃癌中报道的 pCR 病例。它为胃癌患者提供了一种新的治疗方法，即使用 F-FDG PET-CT 评估完全新辅助化疗的反应，结合根治性微创外科治疗，为患者提供最佳的护理。
