Published online Apr 16, 2021. doi: 10.12998/wjcc.v9.i11.2542
Peer-review started: September 14, 2020
First decision: November 23, 2020
Revised: December 3, 2020
Accepted: February 11, 2021
Article in press: February 11, 2021
Published online: April 16, 2021
Processing time: 200 Days and 11.3 Hours
The laparoscopic technique has been widely applied for early gastric cancer, with the advantages of minimal invasion and quick recovery. However, there is no report about the safety and oncological outcome of laparoscopic gastrectomy with D2 lymph node dissection for patients after neoadjuvant chemoradiotherapy.
A 60-year-old man was diagnosed with advanced distal gastric cancer, cT4aN1M0 stage III. The neoadjuvant chemoradiotherapy was performed based on the regimen of gross tumor volume 50G y/25 f and clinical target volume 45 Gy/25 f, as well as concurrent S-1 60 mg Bid. Then laparoscopic distal gastrectomy with D2 lymph node dissection was undertaken successfully for him after achieving partial response evaluated by radiological examination. The patient recovered smoothly without moderate or severe postoperative complications. The postoperative pathological stage was ypT3N0M0 with American Joint Committee on Cancer tumor regression grade 1. He was still in good condition after 5 years of follow-up.
Neoadjuvant chemoradiotherapy followed by laparoscopic technique could be applicable and may achieve satisfactory oncological outcomes. Our finding requires further validation by cohort studies.
Core Tip: The radicalness for locally advanced gastric cancer depends on the completed R0 resection. Although perioperative treatment strategies have been widely used for patients to reinforce the treatment effect, the use of neoadjuvant chemoradiation is controversial, let alone whether the patients can benefit from minimally invasive surgery. We presented the first case treated by laparoscopic distal gastrectomy following neoadjuvant chemoradiation. The perioperative safety and short-term and long-term oncological outcomes in this patient are described in detail.