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病例报告:胃癌合并肝细胞癌患者行手术联合SOX辅助化疗方案

Case report: surgery combined with a SOX adjuvant chemotherapy regimen for patients with gastric adenocarcinoma and hepatocellular carcinoma.

作者信息

Wang Zhe-Yuan, Zhang Lu, Li Zeng-You, Zhang You-Cheng, He Jing-Jing

机构信息

Department of General Surgery, The Second Hospital of Lanzhou University Lanzhou, Gansu, China.

Department of Ultrasound Diagnosis, Gansu Provincial Maternity and Child-care Hospital Lanzhou, Gansu, China.

出版信息

Am J Transl Res. 2025 Jul 25;17(7):5710-5717. doi: 10.62347/FFUV4293. eCollection 2025.

Abstract

Advances in early tumor detection have led to an increase in the reported incidence of multiple primary cancers. However, the concurrent occurrence of gastric adenocarcinoma and hepatocellular carcinoma remains rare. We present the case of a 68-year-old male patient with chronic hepatitis B who was diagnosed with stage Ib liver cancer (T1bN0M0). Gastroscopy revealed a mucosal lesion in the posterior wall of the gastric body, and biopsy confirmed moderately to poorly differentiated adenocarcinoma. The patient underwent laparoscopic gastrectomy combined with partial liver resection, followed by three cycles of S-1 plus oxaliplatin (SOX) chemotherapy. Given the lack of standardized treatment protocols for managing multiple primary cancers, developing a treatment plan for these two synchronous cancers is challenging. This case underscores the importance of early screening for multiple primary cancers and the need for a multidisciplinary approach to formulate an optimal treatment strategy. Furthermore, we conducted a literature review of reports on the simultaneous occurrence of gastric and hepatic cancers over recent decades. Unlike previous studies, we also examined postoperative adjuvant chemotherapy regimens suitable for both gastric adenocarcinoma and hepatocellular carcinoma patients.

摘要

早期肿瘤检测技术的进步导致多原发性癌症的报告发病率有所上升。然而,胃腺癌和肝细胞癌同时发生的情况仍然罕见。我们报告一例68岁慢性乙型肝炎男性患者,诊断为Ib期肝癌(T1bN0M0)。胃镜检查发现胃体后壁有黏膜病变,活检证实为中分化至低分化腺癌。患者接受了腹腔镜胃切除术联合部分肝切除术,随后进行了三个周期的S-1联合奥沙利铂(SOX)化疗。鉴于缺乏管理多原发性癌症的标准化治疗方案,为这两种同步性癌症制定治疗方案具有挑战性。该病例强调了早期筛查多原发性癌症的重要性以及采用多学科方法制定最佳治疗策略的必要性。此外,我们对近几十年来关于胃癌和肝癌同时发生的报告进行了文献综述。与以往研究不同的是,我们还研究了适用于胃腺癌和肝细胞癌患者的术后辅助化疗方案。

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本文引用的文献

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Cancer incidence and mortality in China, 2016.2016年中国癌症的发病率和死亡率
J Natl Cancer Cent. 2022 Feb 27;2(1):1-9. doi: 10.1016/j.jncc.2022.02.002. eCollection 2022 Mar.
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History and emerging trends in chemotherapy for gastric cancer.胃癌化疗的历史与新趋势
Ann Gastroenterol Surg. 2021 Feb 1;5(4):446-456. doi: 10.1002/ags3.12439. eCollection 2021 Jul.

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