内容紹介
A Case of Long-Term Survival of a Patient with Gastric Cancer with Synchronous Liver Metastasis and Portal Vein Thrombus after Multidisciplinary Treatment
Summary
A 77-year-old man was diagnosed with gastric cancer with synchronous single liver metastasis and portal vein thrombus. His HER2 immunohistochemistry tumor score was 3+; therefore, we administered trastuzumab plus capecitabine plus cisplatin. After 2 courses of chemotherapy, we observed disappearance of the portal vein thrombus and tumor reduction as a partial response, according to the RECIST guidelines. We performed distal gastrectomy and right lobectomy; the therapeutic grades of the primary and metastatic tumors were 1a and 2, respectively. We administered postoperative chemotherapy, and no recurrent lesions have appeared 2 years after surgery. Multidisciplinary treatment for gastric cancer with liver metastasis might be a feasible and useful strategy.
要旨
胃体部の高分化型腺癌(HER2強陽性),門脈腫瘍栓を伴う単発肝転移に対して,トラスツズマブ+カペシタビン+シスプラチン療法(HXP療法)を2コース施行した結果,門脈腫瘍栓は消失し,RECIST PRを得た。同時切除を施行後,追加で化学療法を行い,術後2年以上無再発生存中である。HER2強陽性であり肝転移個数が少ない場合には,トラスツズマブを含む化学療法で病巣縮小や微小転移の抑制が期待でき,より安全に根治切除を行い得る可能性がある。門脈腫瘍栓を伴う胃癌肝転移は予後不良とされるが,このような集学的治療は有用であると考えられた。
目次
Summary
A 77-year-old man was diagnosed with gastric cancer with synchronous single liver metastasis and portal vein thrombus. His HER2 immunohistochemistry tumor score was 3+; therefore, we administered trastuzumab plus capecitabine plus cisplatin. After 2 courses of chemotherapy, we observed disappearance of the portal vein thrombus and tumor reduction as a partial response, according to the RECIST guidelines. We performed distal gastrectomy and right lobectomy; the therapeutic grades of the primary and metastatic tumors were 1a and 2, respectively. We administered postoperative chemotherapy, and no recurrent lesions have appeared 2 years after surgery. Multidisciplinary treatment for gastric cancer with liver metastasis might be a feasible and useful strategy.
要旨
胃体部の高分化型腺癌(HER2強陽性),門脈腫瘍栓を伴う単発肝転移に対して,トラスツズマブ+カペシタビン+シスプラチン療法(HXP療法)を2コース施行した結果,門脈腫瘍栓は消失し,RECIST PRを得た。同時切除を施行後,追加で化学療法を行い,術後2年以上無再発生存中である。HER2強陽性であり肝転移個数が少ない場合には,トラスツズマブを含む化学療法で病巣縮小や微小転移の抑制が期待でき,より安全に根治切除を行い得る可能性がある。門脈腫瘍栓を伴う胃癌肝転移は予後不良とされるが,このような集学的治療は有用であると考えられた。