Stage IV gastric cancer successfully treated by multidisciplinary therapy including chemotherapy, immunotherapy, and surgery: a case report
Abstract Background The prognosis of stage IV gastric cancer (GC) still remains unfavorable. Multidisciplinary approaches should therefore be considered to improve the survival of patients with stage IV GC. We report here a case of primary GC with potentially unresectable metastasis, successfully tr...
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| Language: | English |
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Japan Surgical Society
2017-10-01
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| Series: | Surgical Case Reports |
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| Online Access: | http://link.springer.com/article/10.1186/s40792-017-0380-5 |
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| author | Makoto Kawamoto Hideya Onishi Norihiro Koya Hiroyuki Konomi Kenji Mitsugi Risa Tanaka Junichi Motoshita Takashi Morisaki Masafumi Nakamura |
| author_facet | Makoto Kawamoto Hideya Onishi Norihiro Koya Hiroyuki Konomi Kenji Mitsugi Risa Tanaka Junichi Motoshita Takashi Morisaki Masafumi Nakamura |
| author_sort | Makoto Kawamoto |
| collection | DOAJ |
| description | Abstract Background The prognosis of stage IV gastric cancer (GC) still remains unfavorable. Multidisciplinary approaches should therefore be considered to improve the survival of patients with stage IV GC. We report here a case of primary GC with potentially unresectable metastasis, successfully treated by a multidisciplinary approach including chemotherapy, immunotherapy, and surgery. Case presentation A 74-year-old man presented with multiple left neck masses. Abdominal computed tomography showed a thickened gastric wall and multiple lymphadenopathies including left supraclavicular lymph node. Gastroenterological endoscopy revealed tumor lesions in the gastric cardia. Tumor biopsy indicated a pathological diagnosis of poorly differentiated adenocarcinoma. Open left cervical lymph node biopsy showed histological features identical with the gastric tumor, indicating left clavicle lymph node metastasis of GC. After 2 years of chemo-immunotherapy with S-1/CDDP, paclitaxel, and cytokine-activated killer cells, lesions other than the stomach lesion had regressed to undetectable on imaging studies. The patient then underwent laparoscopy-assisted total gastrectomy with Roux-en-Y reconstruction followed by adjuvant chemo-immunotherapy with paclitaxel and S-1 for 1 year, and immunotherapy with tumor lysate-pulsed dendritic cell-activated killer cells for 5 years. The patient remained well after 5 years and 6 months of follow-up, with no signs of recurrence. Conclusion Therapeutic combinations including immunotherapy may thus allow surgery to be performed in patients previously considered unsuitable for surgical intervention, potentially leading to a clinical cure, as in the current case. |
| format | Article |
| id | doaj-art-e4299ec51a2646a38da24723af85b7ae |
| institution | Kabale University |
| issn | 2198-7793 |
| language | English |
| publishDate | 2017-10-01 |
| publisher | Japan Surgical Society |
| record_format | Article |
| series | Surgical Case Reports |
| spelling | doaj-art-e4299ec51a2646a38da24723af85b7ae2025-08-20T03:58:03ZengJapan Surgical SocietySurgical Case Reports2198-77932017-10-01311610.1186/s40792-017-0380-5Stage IV gastric cancer successfully treated by multidisciplinary therapy including chemotherapy, immunotherapy, and surgery: a case reportMakoto Kawamoto0Hideya Onishi1Norihiro Koya2Hiroyuki Konomi3Kenji Mitsugi4Risa Tanaka5Junichi Motoshita6Takashi Morisaki7Masafumi Nakamura8Department of Cancer Therapy and Research, Graduate School of Medical Sciences, Kyushu UniversityDepartment of Cancer Therapy and Research, Graduate School of Medical Sciences, Kyushu UniversityFukuoka General Cancer ClinicDepartment of Surgery, Hamanomachi HospitalDepartment of Medical Oncology, Hamanomachi HospitalDepartment of Medical Oncology, Hamanomachi HospitalDepartment of Pathology, Hamanomachi HospitalFukuoka General Cancer ClinicDepartment of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu UniversityAbstract Background The prognosis of stage IV gastric cancer (GC) still remains unfavorable. Multidisciplinary approaches should therefore be considered to improve the survival of patients with stage IV GC. We report here a case of primary GC with potentially unresectable metastasis, successfully treated by a multidisciplinary approach including chemotherapy, immunotherapy, and surgery. Case presentation A 74-year-old man presented with multiple left neck masses. Abdominal computed tomography showed a thickened gastric wall and multiple lymphadenopathies including left supraclavicular lymph node. Gastroenterological endoscopy revealed tumor lesions in the gastric cardia. Tumor biopsy indicated a pathological diagnosis of poorly differentiated adenocarcinoma. Open left cervical lymph node biopsy showed histological features identical with the gastric tumor, indicating left clavicle lymph node metastasis of GC. After 2 years of chemo-immunotherapy with S-1/CDDP, paclitaxel, and cytokine-activated killer cells, lesions other than the stomach lesion had regressed to undetectable on imaging studies. The patient then underwent laparoscopy-assisted total gastrectomy with Roux-en-Y reconstruction followed by adjuvant chemo-immunotherapy with paclitaxel and S-1 for 1 year, and immunotherapy with tumor lysate-pulsed dendritic cell-activated killer cells for 5 years. The patient remained well after 5 years and 6 months of follow-up, with no signs of recurrence. Conclusion Therapeutic combinations including immunotherapy may thus allow surgery to be performed in patients previously considered unsuitable for surgical intervention, potentially leading to a clinical cure, as in the current case.http://link.springer.com/article/10.1186/s40792-017-0380-5ImmunotherapyCytokine-activated killer cellNKG2DGastric cancerDendritic cell |
| spellingShingle | Makoto Kawamoto Hideya Onishi Norihiro Koya Hiroyuki Konomi Kenji Mitsugi Risa Tanaka Junichi Motoshita Takashi Morisaki Masafumi Nakamura Stage IV gastric cancer successfully treated by multidisciplinary therapy including chemotherapy, immunotherapy, and surgery: a case report Surgical Case Reports Immunotherapy Cytokine-activated killer cell NKG2D Gastric cancer Dendritic cell |
| title | Stage IV gastric cancer successfully treated by multidisciplinary therapy including chemotherapy, immunotherapy, and surgery: a case report |
| title_full | Stage IV gastric cancer successfully treated by multidisciplinary therapy including chemotherapy, immunotherapy, and surgery: a case report |
| title_fullStr | Stage IV gastric cancer successfully treated by multidisciplinary therapy including chemotherapy, immunotherapy, and surgery: a case report |
| title_full_unstemmed | Stage IV gastric cancer successfully treated by multidisciplinary therapy including chemotherapy, immunotherapy, and surgery: a case report |
| title_short | Stage IV gastric cancer successfully treated by multidisciplinary therapy including chemotherapy, immunotherapy, and surgery: a case report |
| title_sort | stage iv gastric cancer successfully treated by multidisciplinary therapy including chemotherapy immunotherapy and surgery a case report |
| topic | Immunotherapy Cytokine-activated killer cell NKG2D Gastric cancer Dendritic cell |
| url | http://link.springer.com/article/10.1186/s40792-017-0380-5 |
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