Successful conversion surgery for unresectable gastric cancer with giant para-aortic lymph node metastasis after downsizing chemotherapy with S-1 and oxaliplatin: a case report

Serizawa, Akiko; Taniguchi, Kiyoaki; Yamada, Takuji; Amano, Kazutaka; Kotake, Sho; Ito, Shunichi; Yamamoto, Masakazu

doi:10.1186/s40792-018-0494-4

Cited by 6 publications

(3 citation statements)

References 12 publications

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“…Many investigators have demonstrated the prognostic impact of conversion surgery after chemotherapy for stage IV gastric cancer [ 6 – 8 ]. However, in most reports, conversion surgery was performed in responders after first-line chemotherapy [ 9 – 11 ], and there are few reports of conversion surgery in responders after second-line chemotherapy with RAM and PTX. Herein, we report a case of long-term survival of a patient with gastric cancer and liver metastases who underwent conversion surgery due to partial response to systemic second-line treatment with RAM plus PTX.…”

Section: Introductionmentioning

confidence: 99%

Successful conversion surgery for stage IV gastric cancer with liver metastases after second-line chemotherapy with ramucirumab and paclitaxel: a case report

et al. 2022

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Background In recent years, conversion surgery after chemotherapy has been considered a promising strategy for improving the prognosis of patients with stage IV gastric cancer. However, there are few reports on conversion gastrectomy after second-line chemotherapy. Here, we report a case of long-term survival of a patient with liver metastases from gastric cancer who underwent conversion surgery after second-line chemotherapy with ramucirumab and paclitaxel. Case presentation A 77-year-old man complaining of weight loss was diagnosed with human epidermal growth factor receptor 2-positive gastric cancer with multiple liver metastases. Although the patient initially received trastuzumab-based chemotherapy, it was discontinued, because he experienced trastuzumab-induced infusion reactions. Thereafter, he was treated with six courses of S-1 plus cisplatin and six courses of ramucirumab plus paclitaxel as the first- and second-line regimens, respectively. The primary tumor and liver metastases remarkably shrank, and the reduction rate of the measurable metastatic liver lesions was 81.1%. According to the Response Evaluation Criteria in Solid Tumors, the patient responded partially. Therefore, he underwent total gastrectomy with D2 lymphadenectomy and partial hepatectomy of segments 3 and 4. Pathological examination revealed tumor invasion into the muscularis propria, a grade 1a histological response, and no lymph node metastases. No viable cancer cells were identified in the specimens resected from liver segments 3 and 4. Accordingly, the patient was pathologically diagnosed with stage IB (ypT2N0M0). Postoperatively, the patient received adjuvant chemotherapy with S-1 for 6 months, and he survived without recurrence for 42 months after conversion surgery. Conclusions Conversion surgery might be clinically useful for improving survival in certain patients with gastric cancer, including those who previously received second-line chemotherapy.

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Section: Introductionmentioning

confidence: 99%

Successful conversion surgery for stage IV gastric cancer with liver metastases after second-line chemotherapy with ramucirumab and paclitaxel: a case report

et al. 2022

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“…Although there are a few case reports on conversion surgery for gastric cancer [5][6][7], none describe a case that was initially diagnosed as cancer of unknown primary (CUP). Here we report a case of successful conversion surgery that was performed after a cervical lymphadenectomy and a bilateral oophorectomy, wherein definitive diagnosis of gastric cancer could only be established about 2 years after an initial diagnosis of CUP.…”

Section: Introductionmentioning

confidence: 99%

Conversion surgery for metastatic gastric cancer at 2 years after initial diagnosis of cancer of unknown primary with metastasis of cervical lymph nodes and ovary: a case report

Suzuki

Hosaka²,

Fukai

et al. 2021

surg case rep

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Background Patients with stage IV gastric cancer have a poor prognosis despite improvements in intensive treatment regimens, including chemotherapy. Recently, conversion surgery has received much attention as it can provide long-term survival in stage IV gastric cancer patients who are responsive to chemotherapy. Herein, we describe the case of a patient who underwent conversion surgery for metastatic gastric cancer that was performed over 2 years after an initial diagnosis of cancer of unknown primary (CUP) with metastasis of the cervical lymph nodes and the ovary. Case presentation A 67-year-old woman with cervical lymphadenopathy was referred to our hospital. Computed tomography showed left cervical lymphadenopathy and bilateral ovarian enlargement. Endoscopic survey revealed no signs of malignancy in the upper or the lower gastrointestinal tract. Pathological findings after cervical lymphadenectomy revealed a signet-ring cell carcinoma and were suggestive of gastric cancer metastases. However, multiple evaluations yielded no evidence of gastric cancer and the patient was diagnosed with CUP. She was prescribed chemotherapy for gastric cancer and underwent bilateral oophorectomy after undergoing chemotherapy for 18 months. Pathologic analysis of oophorectomy tissue revealed findings identical to those seen in the cervical lymph nodes. At about 2 years after the initial diagnosis, an esophagogastroduodenoscopy revealed evidence of gastric cancer. We performed a distal gastrectomy with D2 lymphadenectomy. Her postoperative course was uneventful and she remains alive with no signs of disease recurrence at 3 months post-surgery. Conclusions To the best of our knowledge, this is the first report describing successful conversion surgery for stage IV gastric cancer in a patient whose cancer was definitively diagnosed 2 years after an initial diagnosis of CUP.

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“…Previous studies have shown that when patients present with para-aortic lymph node metastasis, dissection of para-aortic lymph nodes has survival benefits [11,12]. In the past, para-aortic lymph node metastasis is defined as distal metastasis (M1) in TNM staging, in Japan, when carrying out D2 radical surgery and N1 and N2 lymph node dissection, routine dissection of para-aortic lymph nodes is also performed [13,14]. Furthermore, in some medical centers, para-aortic lymph node dissection is also used as a routine surgical procedure to improve the prognosis of advanced gastric cancer [15,16].…”

Section: Introductionmentioning

confidence: 99%

Use of Neural Network in Predicting Gastric Cancer with Para-aortic Lymph Node Metastasis in a Hospital Population Within the Last Two Decades

Zhang¹,

Zhang²,

Xu³

2020

Preprint

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KEYWORDSgastric cancer, para-aortic lymph node metastasis, risk factors, neural network 2 Abstract Background: In clinical practice, the accurate prediction of para-aortic lymph node status and the selection of appropriate surgery methods can significantly affect the prognosis of patients with gastric cancer. In the present study, we reviewed the data of patients who underwent radical gastric cancer surgery with dissection of para-aortic lymph nodes (PANs) within the last 20 years and assessed the possible independent predictors of PAN status.Methods: We included 308 patients with gastric cancer who fulfilled the inclusion criteria, and logistic regression and neural network were utilized to identify the possible independent predictors of PAN status.Results: Logistic regression analysis showed that male sex, Borrmann types III and IV, T4 stage, and pancreatic or splenic metastases were significant risk factors of PAN metastasis after adjusting for other factors, and the accuracy rate was 71.8%. After inputting all parameters into the neural network, the accuracy was 98%.Conclusion: The neural network has significant benefits in predicting PAN status in patients with gastric cancer. The finding of this study may be useful in predicting PAN metastasis. Availability of data and materialThe datasets analyzed during the current study are available from the corresponding author upon reasonable request.

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Successful conversion surgery for unresectable gastric cancer with giant para-aortic lymph node metastasis after downsizing chemotherapy with S-1 and oxaliplatin: a case report

Cited by 6 publications

References 12 publications

Successful conversion surgery for stage IV gastric cancer with liver metastases after second-line chemotherapy with ramucirumab and paclitaxel: a case report

Successful conversion surgery for stage IV gastric cancer with liver metastases after second-line chemotherapy with ramucirumab and paclitaxel: a case report

Conversion surgery for metastatic gastric cancer at 2 years after initial diagnosis of cancer of unknown primary with metastasis of cervical lymph nodes and ovary: a case report

Use of Neural Network in Predicting Gastric Cancer with Para-aortic Lymph Node Metastasis in a Hospital Population Within the Last Two Decades

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