tailieunhanh - Báo cáo khoa học: "Late-onset peritoneal recurrence of advanced gastric cancer 20 years after primary resection"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Late-onset peritoneal recurrence of advanced gastric cancer 20 years after primary resection | Okugawa et al. World Journal of Surgical Oncology 2010 8 104 http content 8 1 104 WORLD JOURNAL OF SURGICAL ONCOLOGY CASE REPORT Open Access Late-onset peritoneal recurrence of advanced gastric cancer 20 years after primary resection Yoshinaga Okugawa Yuji Toiyama Yasuhiro Inoue Susumu Saigusa Minako Kobayashi Koji Tanaka Yasuhiko Mohri Chikao Miki Masato Kusunoki Abstract Late onset of peritoneal recurrence of gastric cancer more than 10 years after surgery is extremely rare and only three cases have been reported. We present the case of a 61-year-old man who was diagnosed finally with peritoneal recurrence of gastric cancer 20 years after primary curative resection. As a result of small-bowel obstruction caused by peritoneal recurrence diverting ileostomy with partial ileal resection was performed. The resected specimen revealed tubular adenocarcinoma that resembled the primary gastric cancer. The clinical course after the second operation was unfavorable and systemic chemotherapy had no effect. He died at 62 years of age 21 years and 7 months after initial gastrectomy. Immunohistochemical analysis using antibodies against proliferating cell nuclear antigen PCNA Ki-67 and p53 was performed to investigate the phenotype of primary and recurrence cancer. Protein expression of proliferation markers such as PCNA and Ki-67 was down-regulated but p53 was overexpressed at the site of recurrence. These data suggest that late peritoneal recurrence has a low proliferation rate and is resistant to chemoradiotherapy. In conclusion we present late onset of peritoneal recurrence of gastric cancer more than 20 years after primary surgery and speculate on the mechanism of late-onset recurrence in our case. Background Gastric cancer is a leading cause of tumor-related deaths with approximately 50 000 individuals dying of gastric cancer each year in Japan. Death from gastric cancer is almost entirely caused by recurrent disease. Peritoneal recurrence represents one of