Salvage surgery after chemotherapy with S-1 plus cisplatin for α-fetoprotein-producing gastric cancer with a portal vein tumor thrombus: a case reportReport as inadecuate




Salvage surgery after chemotherapy with S-1 plus cisplatin for α-fetoprotein-producing gastric cancer with a portal vein tumor thrombus: a case report - Download this document for free, or read online. Document in PDF available to download.

BMC Surgery

, 15:5

Case reports

Abstract

BackgroundPatient with α-Fetoprotein AFP-producing gastric cancer usually has a short survival time due to frequent hepatic and lymph node metastases. Gastric cancer with portal vein tumor thrombus PVTT is rare and has an extremely poor prognosis.

Case presentationA 63-year-old man was found to have a huge Type 3 gastric cancer with a PVTT and a highly elevated serum AFP level. Chemotherapy with S-1 plus cisplatin was given to this patient with unresectable gastric cancer for 4 months. The serum AFP level decreased from 6,160 ng-mL to 60.7 ng-mL with chemotherapy. Since the PVTT disappeared after the chemotherapy, the patient underwent total gastrectomy. Histological findings of the primary tumor after chemotherapy showed poorly differentiated adenocarcinoma without hepatoid cells and viable tumor cells remaining in less than 1-3 of the neoplastic area of mucosa and one lymph node. The cancerous cells were immunohistochemically stained by anti-AFP antibody. The patient has survived for 48 month without recurrence.

ConclusionsAFP-producing gastric cancer with a PVTT has an extremely poor prognosis, but long-term survival was achieved for this dismal condition by salvage surgery after chemotherapy.

KeywordsNeoadjuvant chemotherapy α-fetoprotein-producing gastric cancer Portal vein tumor thrombus AbbreviationsAFP-GCα-Fetoprotein-producing gastric cancer

VEGFVascular epidermal growth factor

PVTTPortal vein tumor thrombus

HCCHepatocellular carcinoma

AFPα-fetoprotein

CTComputed tomography.

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Author: Shigetomi Nakao - Bunzo Nakata - Masashige Tendo - Kenji Kuroda - Takeshi Hori - Mayumi Inaba - Kosei Hirakawa - Tetsuro I

Source: https://link.springer.com/article/10.1186/1471-2482-15-5







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