Complete Response of Locally Advanced Gastric Cancer with Pancreatic Invasion and Gastric Outlet Obstruction after Neoadjuvant Chemotherapy with S-1 and Oxaliplatin
Open Access
- 24 June 2020
- journal article
- research article
- Published by S. Karger AG in Case Reports in Oncology
- Vol. 13 (2), 716-720
- https://doi.org/10.1159/000507983
Abstract
The prognosis of locally advanced gastric cancer is poor even if radical gastrectomy with D2 lymphadenectomy is followed by adjuvant chemotherapy. Hence, neoadjuvant chemotherapy is performed to try to improve the prognosis, as it can significantly downstage the tumor and safely improve the R0 resection rate of patients. Herein, we report a case of locally advanced gastric cancer with pancreatic invasion and gastric outlet obstruction that showed a pathological complete response after neoadjuvant chemotherapy with S-1 and oxaliplatin (SOX). A 74-year-old man presented to our hospital with abdominal pain and pyloric stenosis. CT images revealed a cStage IVb, cT4b tumor in the pancreas, cN1, cM0. Therefore, we performed laparoscopic gastrojejunostomy, and the patient’s oral intake improved after surgery; we then administered neoadjuvant chemotherapy with SOX on postoperative day 18, without any surgical complications. After 3 courses of neoadjuvant chemotherapy, the patient underwent radical distal gastrectomy, thereby avoiding pancreatoduodenectomy. Histopathological examination of the resected sample revealed no residual cancer cells, indicating a pathological complete response. No recurrence has occurred for 1 year after surgery. Thus, neoadjuvant chemotherapy with SOX can help in tumor downstaging and may be a multipotent option for the treatment of locally advanced gastric cancer, such as cases with the invasion of other organs; this treatment can result in improved curability and avoid overinvasive surgery.Keywords
This publication has 8 references indexed in Scilit:
- Perioperative chemotherapy for locally advanced gastric cancer in Japan: current and future perspectives (vol 50, pg 30, 2020)Surgery Today, 2020
- Interpretation of the development of neoadjuvant therapy for gastric cancer based on the vicissitudes of the NCCN guidelinesWorld Journal of Gastrointestinal Oncology, 2020
- [Historical evolution and research progress of perioperative therapy of locally advanced gastric cancer].2019
- Oxaliplatin plus S-1 or capecitabine as neoadjuvant or adjuvant chemotherapy for locally advanced gastric cancer with D2 lymphadenectomy: 5-year follow-up results of a phase II−III randomized trialChinese Journal of Cancer Research, 2018
- Adjuvant capecitabine plus oxaliplatin for gastric cancer after D2 gastrectomy (CLASSIC): 5-year follow-up of an open-label, randomised phase 3 trialThe Lancet Oncology, 2014
- Cancer incidence and mortality worldwide: Sources, methods and major patterns in GLOBOCAN 2012International Journal of Cancer, 2014
- An Updated Meta-Analysis of Randomized Controlled Trial Assessing the Effect of Neoadjuvant Chemotherapy in Advanced Gastric CancerCancer Investigation, 2014
- Palliative gastroenterostomy for pancreatic cancerThe American Journal of Surgery, 1984