Successful conversion surgery for stage IV gastric cancer with liver metastases after second-line chemotherapy with ramucirumab and paclitaxel: a case report
Abstract 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...
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Japan Surgical Society
2022-04-01
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| Series: | Surgical Case Reports |
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| Online Access: | https://doi.org/10.1186/s40792-022-01412-x |
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| author | Kosuke Fukuda Takaaki Arigami Koki Tokuda Shigehiro Yanagita Daisuke Matsushita Yota Kawasaki Satoshi Iino Ken Sasaki Akihiro Nakajo Mari Kirishima Akihide Tanimoto Hitoshi Tsubouchi Hiroshi Kurahara Takao Ohtsuka |
| author_facet | Kosuke Fukuda Takaaki Arigami Koki Tokuda Shigehiro Yanagita Daisuke Matsushita Yota Kawasaki Satoshi Iino Ken Sasaki Akihiro Nakajo Mari Kirishima Akihide Tanimoto Hitoshi Tsubouchi Hiroshi Kurahara Takao Ohtsuka |
| author_sort | Kosuke Fukuda |
| collection | DOAJ |
| description | Abstract 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. |
| format | Article |
| id | doaj-art-548f65af5003452fa00c6488e656cfcf |
| institution | DOAJ |
| issn | 2198-7793 |
| language | English |
| publishDate | 2022-04-01 |
| publisher | Japan Surgical Society |
| record_format | Article |
| series | Surgical Case Reports |
| spelling | doaj-art-548f65af5003452fa00c6488e656cfcf2025-08-20T03:14:46ZengJapan Surgical SocietySurgical Case Reports2198-77932022-04-01811710.1186/s40792-022-01412-xSuccessful conversion surgery for stage IV gastric cancer with liver metastases after second-line chemotherapy with ramucirumab and paclitaxel: a case reportKosuke Fukuda0Takaaki Arigami1Koki Tokuda2Shigehiro Yanagita3Daisuke Matsushita4Yota Kawasaki5Satoshi Iino6Ken Sasaki7Akihiro Nakajo8Mari Kirishima9Akihide Tanimoto10Hitoshi Tsubouchi11Hiroshi Kurahara12Takao Ohtsuka13Department of Digestive Surgery, Breast and Thyroid Surgery, Kagoshima University Graduate School of Medical and Dental SciencesDepartment of Onco-Biological Surgery, Kagoshima University Graduate School of Medical and Dental SciencesDepartment of Gastrointestinal Surgery, Kobayashi City HospitalDepartment of Digestive Surgery, Breast and Thyroid Surgery, Kagoshima University Graduate School of Medical and Dental SciencesDepartment of Digestive Surgery, Breast and Thyroid Surgery, Kagoshima University Graduate School of Medical and Dental SciencesDepartment of Digestive Surgery, Breast and Thyroid Surgery, Kagoshima University Graduate School of Medical and Dental SciencesDepartment of Digestive Surgery, Breast and Thyroid Surgery, Kagoshima University Graduate School of Medical and Dental SciencesDepartment of Digestive Surgery, Breast and Thyroid Surgery, Kagoshima University Graduate School of Medical and Dental SciencesDepartment of Digestive Surgery, Breast and Thyroid Surgery, Kagoshima University Graduate School of Medical and Dental SciencesDepartment of Pathology, Kagoshima University Graduate School of Medical and Dental SciencesDepartment of Pathology, Kagoshima University Graduate School of Medical and Dental SciencesDepartment of Gastrointestinal Surgery, Kobayashi City HospitalDepartment of Digestive Surgery, Breast and Thyroid Surgery, Kagoshima University Graduate School of Medical and Dental SciencesDepartment of Digestive Surgery, Breast and Thyroid Surgery, Kagoshima University Graduate School of Medical and Dental SciencesAbstract 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.https://doi.org/10.1186/s40792-022-01412-xGastric cancerSecond-line chemotherapyConversion surgery |
| spellingShingle | Kosuke Fukuda Takaaki Arigami Koki Tokuda Shigehiro Yanagita Daisuke Matsushita Yota Kawasaki Satoshi Iino Ken Sasaki Akihiro Nakajo Mari Kirishima Akihide Tanimoto Hitoshi Tsubouchi Hiroshi Kurahara Takao Ohtsuka Successful conversion surgery for stage IV gastric cancer with liver metastases after second-line chemotherapy with ramucirumab and paclitaxel: a case report Surgical Case Reports Gastric cancer Second-line chemotherapy Conversion surgery |
| title | Successful conversion surgery for stage IV gastric cancer with liver metastases after second-line chemotherapy with ramucirumab and paclitaxel: a case report |
| title_full | Successful conversion surgery for stage IV gastric cancer with liver metastases after second-line chemotherapy with ramucirumab and paclitaxel: a case report |
| title_fullStr | Successful conversion surgery for stage IV gastric cancer with liver metastases after second-line chemotherapy with ramucirumab and paclitaxel: a case report |
| title_full_unstemmed | Successful conversion surgery for stage IV gastric cancer with liver metastases after second-line chemotherapy with ramucirumab and paclitaxel: a case report |
| title_short | Successful conversion surgery for stage IV gastric cancer with liver metastases after second-line chemotherapy with ramucirumab and paclitaxel: a case report |
| title_sort | successful conversion surgery for stage iv gastric cancer with liver metastases after second line chemotherapy with ramucirumab and paclitaxel a case report |
| topic | Gastric cancer Second-line chemotherapy Conversion surgery |
| url | https://doi.org/10.1186/s40792-022-01412-x |
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