甲胎蛋白产生型胃癌全胃切除术后使用纳武利尤单抗继以伊立替康治疗的长期生存：一例病例报告及文献复习

Long-term survival with nivolumab followed by irinotecan after total gastrectomy in alpha-fetoprotein-producing gastric cancer: a case report and review of the literature.

作者信息

Ota Takayo, Sakashita Katsuya, Sawada Ryugo, Seki Kurumi, Maeda Hiroyuki, Tanaka Noriko, Tsujinaka Toshimasa

机构信息

Department of Medical Oncology, Izumi City General Hospital, 4-5-1, Wake, Izumi, Osaka, 594-0073, Japan.

Department of Surgery, Izumi City General Hospital, Izumi, Osaka, 594-0073, Japan.

出版信息

Surg Case Rep. 2023 May 8;9(1):71. doi: 10.1186/s40792-023-01653-4.

BACKGROUND

Alpha-fetoprotein-producing gastric cancer (AFPGC) is a rare type of aggressive gastric cancer (GC) with a dismal prognosis. We present a patient with AFPGC who achieved long-term survival through a multidisciplinary approach.

CASE PRESENTATION

A 67-year-old man with advanced GC was referred to our hospital for systemic chemotherapy. He was diagnosed with cStage IVB AFPGC. During 2nd-line treatment, we could not control bleeding from the GC itself. After complete resection, during chemotherapy, portal venous tumor thrombi (PVTTs) and liver metastases were identified. With nivolumab followed by irinotecan, the PVTTs and liver metastases disappeared. Without immunotherapy and chemotherapy for 23 months, the patient has survived for 48 months so far with no recurrence of GC.

CONCLUSION

Long-term survival with AFPGC can be accomplished by using several different approaches, such as surgery, immunotherapy, and chemotherapy.

背景

产甲胎蛋白胃癌（AFPGC）是一种罕见的侵袭性胃癌（GC），预后较差。我们报告了一例通过多学科方法实现长期生存的AFPGC患者。

病例介绍

一名67岁的晚期GC男性患者因全身化疗转诊至我院。他被诊断为IVB期AFPGC。在二线治疗期间，我们无法控制GC本身的出血。完全切除后，化疗期间发现门静脉肿瘤血栓（PVTTs）和肝转移。使用纳武单抗后再用伊立替康，PVTTs和肝转移消失。在23个月未进行免疫治疗和化疗的情况下，患者迄今为止已存活48个月，GC无复发。