tailieunhanh - Báo cáo khoa học: "Unresectable gastric cancer with gastric outlet obstruction and distant metastasis responding to intraperitoneal and folfox chemotherapy after palliative laparoscopic gastrojejunostomy: report of a case"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Unresectable gastric cancer with gastric outlet obstruction and distant metastasis responding to intraperitoneal and folfox chemotherapy after palliative laparoscopic gastrojejunostomy: report of a case | Park and Chi World Journal of Surgical Oncology 2010 8 109 http content 8 1 109 5 t WORLD JOURNAL OF SURGICAL ONCOLOGY CASE REPORT Open Access Unresectable gastric cancer with gastric outlet obstruction and distant metastasis responding to intraperitoneal and folfox chemotherapy after palliative laparoscopic gastrojejunostomy report of a case Joong-Min Park1 2 Kyong-Choun Chi1 2 Abstract Background Gastric outlet obstruction GOO caused by unresectable gastric cancer is a challenging aspect of patient care. There have been no reports involving patients with obstructing gastric cancer and several incurable factors curatively treated by multimodal treatments. Case presentation We report a case of 55-year-old man who was diagnosed with a poorly differentiated adenocarcinoma in the pre-pyloric antrum with GOO by gastroscopy. An abdominal computed tomography CT scan revealed thickening of the gastric wall and adjacent fat infiltration and a large amount of food in the stomach suggesting a passage disturbance enlarged lymph nodes along the common hepatic and left gastric arteries and multiple hepatic metastases. The serum carcinoembryonic antigen CEA level was 343 ng ml and the carbohydrate antigen CA 19-9 level was within normal limits. The patient underwent a laparoscopic gastrojejunostomy for palliation of the GOO. On the 3rd and 12th days after surgery he received intraperitoneal chemotherapy with 40 mg of docetaxel and 150 mg of carboplatin. Simultaneously combined chemotherapy with 85 mg m2 of oxaliplatin for the 1st day and 600 mg m2 of 5-FU for 2 days FOLFOX regimen was administered from the 8th post-operative day. After completion of nine courses of FOLFOX the patient achieved a complete response CR with complete disappearance of the primary tumor and the metastatic foci. He underwent a radical subtotal gastrectomy with D3 lymph node dissection 4 months after the initial palliative surgery. The pathologic results revealed no residual primary tumor .