A Case of Advanced Gastric Cancer for Which Curative Resection Was Performed, Despite CEA Elevation

A 32-year-old man was admitted to our hospital with the complaint of epigastric pain. Gastrointestinal endoscopy revealed a type 5 advanced gastric cancer at the posterior wall of the antrum. Contrast-enhanced computed tomography (CT) and endoscopic ultrasonography showed a fluid collection, indicat...

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Bibliographic Details
Published inGan to kagaku ryoho Vol. 42; no. 12; p. 2072
Main Authors Satoh, Ataru, Yamauchi, Junichiro, Yasuta, Sho, Ikeda, Tomoya, Fujita, Shota, Matsuda, Yasufumi, Kobayashi, Shin, Ajiki, Takashi, Tsuchihara, Katsuo, Kondo, Noriko, Ishiyama, Shuichi
Format Journal Article
LanguageJapanese
Published Japan 01.11.2015
Subjects
Adenocarcinoma - drug therapy
Adenocarcinoma - surgery
Adult
Antineoplastic Combined Chemotherapy Protocols - therapeutic use
Carcinoembryonic Antigen - blood
Combined Modality Therapy
Gastrectomy
Humans
Male
Stomach Neoplasms - drug therapy
Stomach Neoplasms - pathology
Stomach Neoplasms - surgery
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Summary:A 32-year-old man was admitted to our hospital with the complaint of epigastric pain. Gastrointestinal endoscopy revealed a type 5 advanced gastric cancer at the posterior wall of the antrum. Contrast-enhanced computed tomography (CT) and endoscopic ultrasonography showed a fluid collection, indicating peritoneal metastasis. CEA levels were elevated, at 16.5 ng/mL. A diagnosis was made of cStage Ⅳ (T4aN3H0P1M1), and he underwent first-line chemotherapy using CDDP and S-1. However, this immediately failed with the severe adverse effect of vomiting.Docetaxel and S-1 were adopted as second-line chemotherapy. Since progression of the disease was confirmed after 8 cycles of second-line chemotherapy, nab-paclitaxel was administered as third-line chemotherapy. Despite a trend of increasing CEA after 4 cycles of third-line chemotherapy, CT revealed a tumor volume reduction as well as the disappearance of the fluid collection, after which staging laparoscopy was performed. Based on the finding that non-curative factors such as fluid collection and peritoneal nodules were not observed, distal gastrectomy was performed. Histopathological examination showed a ypStage ⅠA (T1bN0H0P0M0)tumor with a grade 3 therapeutic response to chemotherapy.The patient is currently doing well with no recurrence 11 months after the operation.
ISSN:0385-0684