Skip to main content
Top
Published in: BMC Cancer 1/2019

Open Access 01-12-2019 | Metastasis | Case report

Long-term survival of an elderly patient with advanced gastric cancer after combination therapy: a case report and literature review

Authors: Qingwei Li, Xuejun Xu, Dan Su, Tianshuo Zhou, Guangyu Wang, Zhiwei Li

Published in: BMC Cancer | Issue 1/2019

Login to get access

Abstract

Background

Gastric cancer ranks the fifth most common cancer, and the third leading cause of cancer-related deaths worldwide. Gastric cancer with liver metastasis (GCLM) has devastating prognosis, however, optimal treatment of GCLM, especially in elderly patients, has yet to be clarified.

Case presentation

A 75-year-old man was diagnosed with advanced gastric cancer (GC), presenting with acute gastrointestinal bleeding and synchronous metastatic lesion in liver. Based on multidisciplinary team (MDT)‘s decision, this patient underwent distal palliative gastrectomy with R1 margin. Histopathological diagnosis was stage IV gastric adenocarcinoma (pT3N2M1), HER2 negative. The patient was treated with chemotherapy and argon-helium cryoablation of liver and lung metastases.HER-2 gene amplification was identified in peripheral blood at later stage of therapy. The patient had been followed-up for 39 months, in sharp contrast to a median survival time of 13.8 months for majority of advanced GC.

Conclusions

Palliative distal gastrectomy in combination with chemotherapy and cryoablation significantly prolongs overall survival of an elderly patient with GCLM.
Appendix
Available only for authorised users
Literature
1.
go back to reference Thun MJ, DeLancey JO, Center MM, Jemal A, Ward EM. The global burden of cancer: priorities for prevention. Carcinogenesis. 2010;31(1):100–10.CrossRef Thun MJ, DeLancey JO, Center MM, Jemal A, Ward EM. The global burden of cancer: priorities for prevention. Carcinogenesis. 2010;31(1):100–10.CrossRef
2.
go back to reference World Health Organization (2014) GLOBOCAN2012: Estimated Cancer Incidence MaPWi. World Health Organization (2014) GLOBOCAN2012: Estimated Cancer Incidence MaPWi.
3.
go back to reference Liu J, Chen L. Current status and progress in gastric cancer with liver metastasis. Chin Med J. 2011;124(3):445–56.PubMed Liu J, Chen L. Current status and progress in gastric cancer with liver metastasis. Chin Med J. 2011;124(3):445–56.PubMed
4.
go back to reference Strong VE, Wu AW, Selby LV, Gonen M, Hsu M, Song KY, Park CH, Coit DG, Ji JF, Brennan MF. Differences in gastric cancer survival between the U.S. and China. J Surg Oncol. 2015;112(1):31–7.CrossRef Strong VE, Wu AW, Selby LV, Gonen M, Hsu M, Song KY, Park CH, Coit DG, Ji JF, Brennan MF. Differences in gastric cancer survival between the U.S. and China. J Surg Oncol. 2015;112(1):31–7.CrossRef
5.
go back to reference Vigano L, Vellone M, Ferrero A, Giuliante F, Nuzzo G, Capussotti L. Liver resection for gastric cancer metastases. Hepato-gastroenterology. 2013;60(123):557–62.PubMed Vigano L, Vellone M, Ferrero A, Giuliante F, Nuzzo G, Capussotti L. Liver resection for gastric cancer metastases. Hepato-gastroenterology. 2013;60(123):557–62.PubMed
6.
go back to reference Hwang SE, Yang DH, Kim CY. Prognostic factors for survival in patients with hepatic recurrence after curative resection of gastric cancer. World J Surg. 2009;33(7):1468–72.CrossRef Hwang SE, Yang DH, Kim CY. Prognostic factors for survival in patients with hepatic recurrence after curative resection of gastric cancer. World J Surg. 2009;33(7):1468–72.CrossRef
7.
go back to reference Sakamoto Y, Sano T, Shimada K, Esaki M, Saka M, Fukagawa T, Katai H, Kosuge T, Sasako M. Favorable indications for hepatectomy in patients with liver metastasis from gastric cancer. J Surg Oncol. 2007;95(7):534–9.CrossRef Sakamoto Y, Sano T, Shimada K, Esaki M, Saka M, Fukagawa T, Katai H, Kosuge T, Sasako M. Favorable indications for hepatectomy in patients with liver metastasis from gastric cancer. J Surg Oncol. 2007;95(7):534–9.CrossRef
8.
go back to reference Takemura N, Saiura A, Koga R, Arita J, Yoshioka R, Ono Y, Hiki N, Sano T, Yamamoto J, Kokudo N, et al. Long-term outcomes after surgical resection for gastric cancer liver metastasis: an analysis of 64 macroscopically complete resections. Langenbeck's Arch Surg. 2012;397(6):951–7.CrossRef Takemura N, Saiura A, Koga R, Arita J, Yoshioka R, Ono Y, Hiki N, Sano T, Yamamoto J, Kokudo N, et al. Long-term outcomes after surgical resection for gastric cancer liver metastasis: an analysis of 64 macroscopically complete resections. Langenbeck's Arch Surg. 2012;397(6):951–7.CrossRef
9.
go back to reference Fukuchi M, Ishiguro T, Ogata K, Suzuki O, Kumagai Y, Ishibashi K, Ishida H, Kuwano H, Mochiki E. Prognostic role of conversion surgery for Unresectable gastric Cancer. Ann Surg Oncol. 2015;22(11):3618–24.CrossRef Fukuchi M, Ishiguro T, Ogata K, Suzuki O, Kumagai Y, Ishibashi K, Ishida H, Kuwano H, Mochiki E. Prognostic role of conversion surgery for Unresectable gastric Cancer. Ann Surg Oncol. 2015;22(11):3618–24.CrossRef
10.
go back to reference Fujitani K, Yang HK, Mizusawa J, Kim YW, Terashima M, Han SU, Iwasaki Y, Hyung WJ, Takagane A, Park DJ, et al. Gastrectomy plus chemotherapy versus chemotherapy alone for advanced gastric cancer with a single non-curable factor (REGATTA): a phase 3, randomised controlled trial. Lancet Oncol. 2016;17(3):309–18.CrossRef Fujitani K, Yang HK, Mizusawa J, Kim YW, Terashima M, Han SU, Iwasaki Y, Hyung WJ, Takagane A, Park DJ, et al. Gastrectomy plus chemotherapy versus chemotherapy alone for advanced gastric cancer with a single non-curable factor (REGATTA): a phase 3, randomised controlled trial. Lancet Oncol. 2016;17(3):309–18.CrossRef
11.
go back to reference Edge SB, Compton CC. The American joint committee on Cancer: the 7th edition of the AJCC Cancer staging manual and the future of TNM. Ann Surg Oncol. 2010;17(6):1471–4.CrossRef Edge SB, Compton CC. The American joint committee on Cancer: the 7th edition of the AJCC Cancer staging manual and the future of TNM. Ann Surg Oncol. 2010;17(6):1471–4.CrossRef
12.
go back to reference McCarter MD, Fong Y. Role for surgical cytoreduction in multimodality treatments for cancer. Ann Surg Oncol. 2001;8(1):38–43.CrossRef McCarter MD, Fong Y. Role for surgical cytoreduction in multimodality treatments for cancer. Ann Surg Oncol. 2001;8(1):38–43.CrossRef
13.
go back to reference Saidi RF, ReMine SG, Dudrick PS, Hanna NN. Is there a role for palliative gastrectomy in patients with stage IV gastric cancer? World J Surg. 2006;30(1):21–7.CrossRef Saidi RF, ReMine SG, Dudrick PS, Hanna NN. Is there a role for palliative gastrectomy in patients with stage IV gastric cancer? World J Surg. 2006;30(1):21–7.CrossRef
14.
go back to reference Cheon S, Rha S, Jeung H-C, Im C-K, Kim S, Kim H, Ahn J, Roh J, Noh S, Chung H. Survival benefit of combined curative resection of the stomach (D2 resection) and liver in gastric cancer patients with liver metastases. Ann Oncol. 2008;19(6):1146–53.CrossRef Cheon S, Rha S, Jeung H-C, Im C-K, Kim S, Kim H, Ahn J, Roh J, Noh S, Chung H. Survival benefit of combined curative resection of the stomach (D2 resection) and liver in gastric cancer patients with liver metastases. Ann Oncol. 2008;19(6):1146–53.CrossRef
15.
go back to reference Sakamoto Y, Ohyama S, Yamamoto J, Yamada K, Seki M, Ohta K-i, Kokudo N, Yamaguchi T, Muto T, Makuuchi M. Surgical resection of liver metastases of gastric cancer: an analysis of a 17-year experience with 22 patients. Surgery. 2003;133(5):507–11.CrossRef Sakamoto Y, Ohyama S, Yamamoto J, Yamada K, Seki M, Ohta K-i, Kokudo N, Yamaguchi T, Muto T, Makuuchi M. Surgical resection of liver metastases of gastric cancer: an analysis of a 17-year experience with 22 patients. Surgery. 2003;133(5):507–11.CrossRef
16.
go back to reference Nomura T, Kamio Y, Takasu N, Moriya T, Takeshita A, Mizutani M, Hachiya O, Hirai I, Kimura W. Intrahepatic micrometastases around liver metastases from gastric cancer. J Hepato-Biliary-Pancreat Surg. 2009;16(4):493–501.CrossRef Nomura T, Kamio Y, Takasu N, Moriya T, Takeshita A, Mizutani M, Hachiya O, Hirai I, Kimura W. Intrahepatic micrometastases around liver metastases from gastric cancer. J Hepato-Biliary-Pancreat Surg. 2009;16(4):493–501.CrossRef
17.
go back to reference Kakeji Y, Morita M, Maehara Y. Strategies for treating liver metastasis from gastric cancer. Surg Today. 2010;40(4):287–94.CrossRef Kakeji Y, Morita M, Maehara Y. Strategies for treating liver metastasis from gastric cancer. Surg Today. 2010;40(4):287–94.CrossRef
18.
go back to reference Kim HR, Ha Cheon S, Lee K-H, Ryun Ahn J, Jeung H-C, Sook Lee S, Cheol Chung H, Hoon Noh S, Young Rha S. Efficacy and feasibility of radiofrequency ablation for liver metastases from gastric adenocarcinoma. Int J Hyperth. 2010;26(4):305–15.CrossRef Kim HR, Ha Cheon S, Lee K-H, Ryun Ahn J, Jeung H-C, Sook Lee S, Cheol Chung H, Hoon Noh S, Young Rha S. Efficacy and feasibility of radiofrequency ablation for liver metastases from gastric adenocarcinoma. Int J Hyperth. 2010;26(4):305–15.CrossRef
19.
go back to reference Kim HO, Hwang SI, Hong HP, Yoo CH. Radiofrequency ablation for metachronous hepatic metastases from gastric cancer. Surg Laparosc Endosc Percutan Tech. 2009;19(3):208–12.CrossRef Kim HO, Hwang SI, Hong HP, Yoo CH. Radiofrequency ablation for metachronous hepatic metastases from gastric cancer. Surg Laparosc Endosc Percutan Tech. 2009;19(3):208–12.CrossRef
20.
go back to reference Boutros C, Somasundar P, Garrean S, Saied A, Espat N. Microwave coagulation therapy for hepatic tumors: review of the literature and critical analysis. Surg Oncol. 2010;19(1):e22–32.CrossRef Boutros C, Somasundar P, Garrean S, Saied A, Espat N. Microwave coagulation therapy for hepatic tumors: review of the literature and critical analysis. Surg Oncol. 2010;19(1):e22–32.CrossRef
21.
go back to reference Yu J, Liang P, Yu X, Liu F, Chen L, Wang Y. A comparison of microwave ablation and bipolar radiofrequency ablation both with an internally cooled probe: results in ex vivo and in vivo porcine livers. Eur J Radiol. 2011;79(1):124–30.CrossRef Yu J, Liang P, Yu X, Liu F, Chen L, Wang Y. A comparison of microwave ablation and bipolar radiofrequency ablation both with an internally cooled probe: results in ex vivo and in vivo porcine livers. Eur J Radiol. 2011;79(1):124–30.CrossRef
22.
go back to reference Mayo SC, Pawlik TM. Thermal ablative therapies for secondary hepatic malignancies. Cancer J. 2010;16(2):111–7.CrossRef Mayo SC, Pawlik TM. Thermal ablative therapies for secondary hepatic malignancies. Cancer J. 2010;16(2):111–7.CrossRef
23.
go back to reference Chen J, Tang Z, Dong X, Gao S, Fang H, Wu D, Xiang D, Zhang S. Radiofrequency ablation for liver metastasis from gastric cancer. Eur J Surg Oncol. 2013;39(7):701–6.CrossRef Chen J, Tang Z, Dong X, Gao S, Fang H, Wu D, Xiang D, Zhang S. Radiofrequency ablation for liver metastasis from gastric cancer. Eur J Surg Oncol. 2013;39(7):701–6.CrossRef
24.
go back to reference Guner A, Son T, Cho I, Kwon IG, An JY, Kim HI, Cheong JH, Noh SH, Hyung WJ. Liver-directed treatments for liver metastasis from gastric adenocarcinoma: comparison between liver resection and radiofrequency ablation. Gastric Cancer. 2016;19(3):951–60.CrossRef Guner A, Son T, Cho I, Kwon IG, An JY, Kim HI, Cheong JH, Noh SH, Hyung WJ. Liver-directed treatments for liver metastasis from gastric adenocarcinoma: comparison between liver resection and radiofrequency ablation. Gastric Cancer. 2016;19(3):951–60.CrossRef
25.
go back to reference Nienhueser H, Kunzmann R, Sisic L, Blank S, Strowitzk MJ, Bruckner T, Jager D, Weichert W, Ulrich A, Buchler MW, et al. Surgery of gastric cancer and esophageal cancer: does age matter? J Surg Oncol. 2015;112(4):387–95.CrossRef Nienhueser H, Kunzmann R, Sisic L, Blank S, Strowitzk MJ, Bruckner T, Jager D, Weichert W, Ulrich A, Buchler MW, et al. Surgery of gastric cancer and esophageal cancer: does age matter? J Surg Oncol. 2015;112(4):387–95.CrossRef
26.
go back to reference Schmidt T, Alldinger I, Blank S, Klose J, Springfeld C, Dreikhausen L, Weichert W, Grenacher L, Bruckner T, Lordick F, et al. Surgery in oesophago-gastric cancer with metastatic disease: treatment, prognosis and preoperative patient selection. Eur J Surg Oncol. 2015;41(10):1340–7.CrossRef Schmidt T, Alldinger I, Blank S, Klose J, Springfeld C, Dreikhausen L, Weichert W, Grenacher L, Bruckner T, Lordick F, et al. Surgery in oesophago-gastric cancer with metastatic disease: treatment, prognosis and preoperative patient selection. Eur J Surg Oncol. 2015;41(10):1340–7.CrossRef
27.
go back to reference Association JGC. Japanese gastric cancer treatment guidelines 2014 (ver. 4). Gastric Cancer. 2017;20(1):1–19.CrossRef Association JGC. Japanese gastric cancer treatment guidelines 2014 (ver. 4). Gastric Cancer. 2017;20(1):1–19.CrossRef
28.
go back to reference De La Cruz LM, Harhay MO, Zhang P, Ugras S. Impact of neoadjuvant chemotherapy on breast Cancer subtype: does subtype change and, if so, how? : IHC profile and neoadjuvant chemotherapy. Ann Surg Oncol. 2018;25(12):3535–40.CrossRef De La Cruz LM, Harhay MO, Zhang P, Ugras S. Impact of neoadjuvant chemotherapy on breast Cancer subtype: does subtype change and, if so, how? : IHC profile and neoadjuvant chemotherapy. Ann Surg Oncol. 2018;25(12):3535–40.CrossRef
29.
go back to reference Niikura N, Tomotaki A, Miyata H, Iwamoto T, Kawai M, Anan K, Hayashi N, Aogi K, Ishida T, Masuoka H, et al. Changes in tumor expression of HER2 and hormone receptors status after neoadjuvant chemotherapy in 21,755 patients from the Japanese breast cancer registry. Ann Oncol. 2016;27(3):480–7.CrossRef Niikura N, Tomotaki A, Miyata H, Iwamoto T, Kawai M, Anan K, Hayashi N, Aogi K, Ishida T, Masuoka H, et al. Changes in tumor expression of HER2 and hormone receptors status after neoadjuvant chemotherapy in 21,755 patients from the Japanese breast cancer registry. Ann Oncol. 2016;27(3):480–7.CrossRef
Metadata
Title
Long-term survival of an elderly patient with advanced gastric cancer after combination therapy: a case report and literature review
Authors
Qingwei Li
Xuejun Xu
Dan Su
Tianshuo Zhou
Guangyu Wang
Zhiwei Li
Publication date
01-12-2019
Publisher
BioMed Central
Published in
BMC Cancer / Issue 1/2019
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/s12885-019-5683-4

Other articles of this Issue 1/2019

BMC Cancer 1/2019 Go to the issue
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine