Department of Gastrointestinal Surgery, Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou Province, China.
Guizhou Medical University, Guiyang, Guizhou Province, China.
Medicine (Baltimore). 2024 Jan 19;103(3):e36927. doi: 10.1097/MD.0000000000036927.
Most Chinese patients with locally advanced gastric cancer at diagnosis have an overall 5-year survival rate of <50%. Surgical resection alone is not suitable for patients with locally advanced gastric cancer. Currently, comprehensive treatment is the focus of locally advanced gastric cancer.
The patient, a 56-year-old female, was admitted to the hospital because of "4 + months of double hydronephrosis found during a physical examination." Who was admitted for computer tomography and gastroscopy examinations, and take pathological tissue specimens during endoscopic examination.
Computed tomography assessment indicated ulcerative gastric cancer with an abdominal implant, bladder, and bone metastases. An endoscopic examination revealed that the ulcer of the gastric angle was huge, and through relevant auxiliary examinations, the diagnosis of this disease is gastric cancer complicated with multiple metastases to bladder, rectum, lumbar spine, and peritoneum. Clinically diagnosed as cT4bN3M1.
The patient is currently undergoing first, second, and third line neoadjuvant therapy, combined with immunotherapy, targeted therapy, neoadjuvant intraperitoneal systemic chemotherapy, nutritional support, and other treatment plans.
After 15 cycles of treatment, the progression-free survival had reached 15 months. The patient had an NRS2002 score of 1, an ECOG score of I, a quality of life score of 55, albumin of 35.27 g/L, and a decrease in abdominal and pelvic fluid accumulation and exudation compared to before.
We demonstrated high survival of almost 3 years in a patient with gastric cancer that was complicated by bone, peritoneal, rectal, and bladder metastases. The combination of immunotherapy, targeted therapy, and neoadjuvant intraperitoneal systemic chemotherapy, along with the maintenance of nutritional status and CTCs could be a valuable modality for the subsequent treatment and observation of similar patients.
大多数中国局部晚期胃癌患者的总体 5 年生存率<50%。单纯手术切除不适合局部晚期胃癌患者。目前，综合治疗是局部晚期胃癌的重点。
患者，女，56 岁，因“体检发现双肾积水 4+月”入院。入院行计算机断层扫描和胃镜检查，并在内镜检查时取病理组织标本。
计算机断层扫描评估显示溃疡型胃癌伴腹部种植、膀胱和骨转移。内镜检查发现胃角溃疡巨大，通过相关辅助检查，诊断为胃癌伴膀胱、直肠、腰椎和腹膜多发转移。临床诊断为 cT4bN3M1。
患者目前正在接受一线、二线和三线新辅助治疗，联合免疫治疗、靶向治疗、新辅助腹腔全身化疗、营养支持等治疗方案。
治疗 15 个周期后，无进展生存期达到 15 个月。患者的 NRS2002 评分为 1，ECOG 评分为 I，生活质量评分为 55，白蛋白为 35.27g/L，与治疗前相比，腹部和盆腔积液积聚和渗出减少。
我们证明了一名患有胃癌合并骨、腹膜、直肠和膀胱转移的患者的近 3 年生存率较高。免疫治疗、靶向治疗和新辅助腹腔全身化疗的联合，以及维持营养状况和 CTCs，可以为后续治疗和观察类似患者提供有价值的方法。
