Type 4 Gastric Cancer with Peritoneal Dissemination, Successfuly Treated with Multimodal Therapy, Report of a Case Yoshiro Saikawa 1 1Department of Surgery, Keio University School of Medicine Keyword: S-1 , CPT-11 , cisplatin , 4型胃癌 , 腹膜播種 pp.1027-1030
Published Date 2005/6/25
DOI https://doi.org/10.11477/mf.1403100220
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 A forty-year-old male, with abdominal distension and gastric pain as his main complaint, was diagnosed, by endoscopy and abdominal computed tomography, as type 4 gastric cancer with ascites. It was confirmed as T3N1M0H0P1, cStage IV gastric cancer. As curative treatment was impossible by surgery, S-1/low dose CDDP (TSLD) with radiation therapy was chosen as the initial treatment. After 2 cycles of TSLD with 40 Gy radiation therapy, disappearance of ascites and improved appearance of the stomach were confirmed. However, solitary liver metastasis was detected at this time. Chemotherapeutic regimen was changed to the CPT-11/S-1 regimen against the liver tumor, on an outpatient basis. This resulted in complete response of the liver metastasis at 8 months after the initial treatment. In accord with the patient's wish, curative surgery (total gastrectomy and appropriate lymph node dissection) was performed 11 months after the initial treatment. The patient recovered without any postoperative complication. Histological investigation diagnosed pT3 (SE) N0M0P0, pStage II gastric cancer. He is alive without recurrence of the disease at 1 year and 5 months after initial treatment.

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