Pathological complete response after intraperitoneal paclitaxel and systemic combined chemotherapy in a patient with peritoneal metastases from gastric cancer: a case report
Abstract Background Despite recent progress in systemic chemotherapy, the prognosis of patients with peritoneal metastases from gastric cancer is still poor. Efficacious intraperitoneal and systemic combination chemotherapy regimens to treat patients with peritoneal metastases have recently been dev...
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| Format: | Article |
| Language: | English |
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SpringerOpen
2020-03-01
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| Series: | Surgical Case Reports |
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| Online Access: | http://link.springer.com/article/10.1186/s40792-020-00818-9 |
| _version_ | 1811206557329784832 |
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| author | Yoshiyuki Meguro Hironori Yamaguchi Joji Kitayama Rihito Kanamaru Shiro Matsumoto Takashi Ui Hidenori Haruta Kentaro Kurashina Shin Saito Yoshinori Hosoya Alan Kawarai Lefor Naohiro Sata |
| author_facet | Yoshiyuki Meguro Hironori Yamaguchi Joji Kitayama Rihito Kanamaru Shiro Matsumoto Takashi Ui Hidenori Haruta Kentaro Kurashina Shin Saito Yoshinori Hosoya Alan Kawarai Lefor Naohiro Sata |
| author_sort | Yoshiyuki Meguro |
| collection | DOAJ |
| description | Abstract Background Despite recent progress in systemic chemotherapy, the prognosis of patients with peritoneal metastases from gastric cancer is still poor. Efficacious intraperitoneal and systemic combination chemotherapy regimens to treat patients with peritoneal metastases have recently been developed. Case presentation A 74-year-old man with gastric cancer T4b (transverse mesocolon) N3 M1 (peritoneum) received combination chemotherapy with intraperitoneal administration of paclitaxel, intravenous oxaliplatin, and oral S-1. Eight courses of combined chemotherapy had remarkable anti-tumor effects on the primary lesion, lymph node metastases, and peritoneal metastases. Total gastrectomy with regional lymph node dissection was performed. Pathological examination revealed no viable tumor cells in the resected specimens. After gastrectomy, the patient received 25 courses of the same chemotherapy without oxaliplatin and has no evidence of recurrence 24 months later. Discussion Therapeutic approaches including systemic chemotherapy, extended resection, and heated intraperitoneal chemotherapy have been used to treat patients with peritoneal metastases. Repeat therapy with intraperitoneal paclitaxel has been used recently. Intraperitoneal administration of paclitaxel results in prolonged retention in the peritoneal cavity with effects against peritoneal metastases. Repeated administration of paclitaxel does not cause adhesions in the peritoneal cavity. When combination chemotherapy is effective, salvage gastrectomy is a promising option with minimal morbidity and mortality. Conclusion Combined chemotherapy with intraperitoneal paclitaxel and systemic chemotherapy followed by gastrectomy is a promising strategy for patients with advanced gastric cancer and peritoneal metastases. |
| first_indexed | 2024-04-12T03:50:14Z |
| format | Article |
| id | doaj.art-e5fe26e54a574d71bb163affd8b097d8 |
| institution | Directory Open Access Journal |
| issn | 2198-7793 |
| language | English |
| last_indexed | 2024-04-12T03:50:14Z |
| publishDate | 2020-03-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Surgical Case Reports |
| spelling | doaj.art-e5fe26e54a574d71bb163affd8b097d82022-12-22T03:49:01ZengSpringerOpenSurgical Case Reports2198-77932020-03-01611510.1186/s40792-020-00818-9Pathological complete response after intraperitoneal paclitaxel and systemic combined chemotherapy in a patient with peritoneal metastases from gastric cancer: a case reportYoshiyuki Meguro0Hironori Yamaguchi1Joji Kitayama2Rihito Kanamaru3Shiro Matsumoto4Takashi Ui5Hidenori Haruta6Kentaro Kurashina7Shin Saito8Yoshinori Hosoya9Alan Kawarai Lefor10Naohiro Sata11Department of Clinical Oncology, Division of Gastroenterological, General and Transplant Surgery, Jichi Medical University School of MedicineDepartment of Clinical Oncology, Jichi Medical University School of MedicineDepartment of Clinical Oncology, Division of Gastroenterological, General and Transplant Surgery, Jichi Medical University School of MedicineDepartment of Clinical Oncology, Division of Gastroenterological, General and Transplant Surgery, Jichi Medical University School of MedicineDepartment of Clinical Oncology, Division of Gastroenterological, General and Transplant Surgery, Jichi Medical University School of MedicineDepartment of Clinical Oncology, Division of Gastroenterological, General and Transplant Surgery, Jichi Medical University School of MedicineDepartment of Clinical Oncology, Division of Gastroenterological, General and Transplant Surgery, Jichi Medical University School of MedicineDepartment of Clinical Oncology, Division of Gastroenterological, General and Transplant Surgery, Jichi Medical University School of MedicineDepartment of Clinical Oncology, Division of Gastroenterological, General and Transplant Surgery, Jichi Medical University School of MedicineDepartment of Clinical Oncology, Division of Gastroenterological, General and Transplant Surgery, Jichi Medical University School of MedicineDepartment of Clinical Oncology, Division of Gastroenterological, General and Transplant Surgery, Jichi Medical University School of MedicineDepartment of Clinical Oncology, Division of Gastroenterological, General and Transplant Surgery, Jichi Medical University School of MedicineAbstract Background Despite recent progress in systemic chemotherapy, the prognosis of patients with peritoneal metastases from gastric cancer is still poor. Efficacious intraperitoneal and systemic combination chemotherapy regimens to treat patients with peritoneal metastases have recently been developed. Case presentation A 74-year-old man with gastric cancer T4b (transverse mesocolon) N3 M1 (peritoneum) received combination chemotherapy with intraperitoneal administration of paclitaxel, intravenous oxaliplatin, and oral S-1. Eight courses of combined chemotherapy had remarkable anti-tumor effects on the primary lesion, lymph node metastases, and peritoneal metastases. Total gastrectomy with regional lymph node dissection was performed. Pathological examination revealed no viable tumor cells in the resected specimens. After gastrectomy, the patient received 25 courses of the same chemotherapy without oxaliplatin and has no evidence of recurrence 24 months later. Discussion Therapeutic approaches including systemic chemotherapy, extended resection, and heated intraperitoneal chemotherapy have been used to treat patients with peritoneal metastases. Repeat therapy with intraperitoneal paclitaxel has been used recently. Intraperitoneal administration of paclitaxel results in prolonged retention in the peritoneal cavity with effects against peritoneal metastases. Repeated administration of paclitaxel does not cause adhesions in the peritoneal cavity. When combination chemotherapy is effective, salvage gastrectomy is a promising option with minimal morbidity and mortality. Conclusion Combined chemotherapy with intraperitoneal paclitaxel and systemic chemotherapy followed by gastrectomy is a promising strategy for patients with advanced gastric cancer and peritoneal metastases.http://link.springer.com/article/10.1186/s40792-020-00818-9Gastric cancerPeritoneal metastasisIntraperitoneal chemotherapyPaclitaxelPathological complete response |
| spellingShingle | Yoshiyuki Meguro Hironori Yamaguchi Joji Kitayama Rihito Kanamaru Shiro Matsumoto Takashi Ui Hidenori Haruta Kentaro Kurashina Shin Saito Yoshinori Hosoya Alan Kawarai Lefor Naohiro Sata Pathological complete response after intraperitoneal paclitaxel and systemic combined chemotherapy in a patient with peritoneal metastases from gastric cancer: a case report Surgical Case Reports Gastric cancer Peritoneal metastasis Intraperitoneal chemotherapy Paclitaxel Pathological complete response |
| title | Pathological complete response after intraperitoneal paclitaxel and systemic combined chemotherapy in a patient with peritoneal metastases from gastric cancer: a case report |
| title_full | Pathological complete response after intraperitoneal paclitaxel and systemic combined chemotherapy in a patient with peritoneal metastases from gastric cancer: a case report |
| title_fullStr | Pathological complete response after intraperitoneal paclitaxel and systemic combined chemotherapy in a patient with peritoneal metastases from gastric cancer: a case report |
| title_full_unstemmed | Pathological complete response after intraperitoneal paclitaxel and systemic combined chemotherapy in a patient with peritoneal metastases from gastric cancer: a case report |
| title_short | Pathological complete response after intraperitoneal paclitaxel and systemic combined chemotherapy in a patient with peritoneal metastases from gastric cancer: a case report |
| title_sort | pathological complete response after intraperitoneal paclitaxel and systemic combined chemotherapy in a patient with peritoneal metastases from gastric cancer a case report |
| topic | Gastric cancer Peritoneal metastasis Intraperitoneal chemotherapy Paclitaxel Pathological complete response |
| url | http://link.springer.com/article/10.1186/s40792-020-00818-9 |
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