Okumura Y, Ohashi M, Nunobe S, Iwanaga T, Kanda T, Iwasaki Y. Gastrojejunostomy followed by induction chemotherapy for incurable gastric cancer with outlet obstruction. World J Gastroenterol 2010; 16(34): 4367-4370 [PMID: 20818823 DOI: 10.3748/wjg.v16.i34.4367]
Corresponding Author of This Article
Manabu Ohashi, MD, PhD, Department of Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, 3-18-22, Honkomagome, Bunkyo-ku, Tokyo 113-8677, Japan. ohamana@cick.jp
Article-Type of This Article
Case Report
Open-Access Policy of This Article
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Yasuhiro Okumura, Manabu Ohashi, Tomohiro Iwanaga, Yoshiaki Iwasaki, Department of Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, 3-18-22, Honkomagome, Bunkyo-ku, Tokyo 113-8677, Japan
Souya Nunobe, Department of Gastrointestinal Surgery, Tokyo University Hospital, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
Tatsuo Kanda, Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata 951-8510, Japan
Author contributions: Ohashi M, Nunobe S and Iwasaki Y designed the research; Okumura Y and Ohashi M wrote the paper; Iwanaga T did the clinical work; Kanda T reviewed the paper.
Correspondence to: Manabu Ohashi, MD, PhD, Department of Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, 3-18-22, Honkomagome, Bunkyo-ku, Tokyo 113-8677, Japan. ohamana@cick.jp
Telephone: +81-3-38232101 Fax: +81-3-38241552
Received: April 7, 2010 Revised: May 14, 2010 Accepted: May 21, 2010 Published online: September 14, 2010
Abstract
A 72-year-old male gastric cancer patient with outlet obstruction underwent laparoscopic exploration. The examination disclosed intraperitoneal free cancer cells with no overt peritoneal, lymphatic, or hepatic metastasis. The patient underwent laparoscopy-assisted gastrojejunostomy (LAGJ) and started chemotherapy with S-1 plus cisplatin on postoperative day 13. Three course of the chemotherapy shrank the tumor markedly. Then, the patient underwent gastrectomy with a curative intent. Laparotomy revealed no intraperitoneal free cancer cells, and microscopically complete resection was achieved. The patient received S-1 chemotherapy as postoperative adjuvant treatment for 1 year, and is still alive with no evidence of peritoneal recurrence. LAGJ followed by S-1 plus cisplatin is one of the optional treatments that should be considered for patients with outlet obstruction as it may widen opportunities for potentially curative resection.
