We report a patient with unresectable gastric cancer who was effectively treated with S-1 after gastrojejunostomy. A 64-year-old man was referred to our hospital for anorexia and epigastric palpable mass. Upper gastrointestinal endoscopy revealed an ulcerous tumor in the antrum of the stomach, and gastric roentgenography showed pyloric stenosis. CT showed simultaneous multiple liver metastases. We performed gastrojejunostomy to allow oral intake. He was treated with daily oral administration of 120-80 mg S-1 for two weeks followed by one week rest as one course. The treatment was repeated for 19 courses until remission was observed. Weekly paclitaxel therapy (80 mg/m(2)/week) was then chosen as second-line chemotherapy. Administration was continued for three weeks with one-week rest. The treatment course was repeated for 6 courses. Bi-weekly administration of CPT-11 (80 mg) and CDDP (30 mg) was chosen as third-line chemotherapy. He died of progressive disease 2 years and 2 months after surgery. During chemotherapy, he maintained a performance status of 0 to 1, and maintained quality of life. This case suggested that the gastrojejunostomy was a useful method for treating unresectable gastric cancer, allowing the possibility of oral intake, and the use of S-1.
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Gan To Kagaku Ryoho
December 2024
Dept. of Surgery, Nara Prefecture General Medical Center.
A 70-year-old man was admitted to a local hospital with epigastric pain and diagnosed with type-2 gastric cancer. Contrast-enhanced CT scan showed metastases in S3 and S8 of the liver, and the tumor was classified as type cT4aN2H1, cStage ⅣB. Nivolumab monotherapy was initiated after failure of treatment with S-1 plus oxaliplatin and ramucirumab.
View Article and Find Full Text PDFPeerJ
December 2024
Department of Oncology, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China.
Background: Recent studies have revealed that inflammatory factors and nutritional status of patients with advanced gastric cancer (AGC) are related to the efficacy of drug therapy and patient prognosis. This study seeks to evaluate the correlation between inflammatory markers, nutritional status, and clinical outcomes of immune checkpoint inhibitor (ICI)-based therapies among inoperable AGC patients.
Method: This retrospective study included 88 AGC patients who received ICIs combined with chemotherapy.
Jpn J Clin Oncol
December 2024
Gastrointestinal Medical Oncology Division, National Cancer Center Hospital, Tokyo, Japan.
The standard approach for stage IV gastric cancer is palliative chemotherapy. However, despite the advancements in various chemotherapy regimens, the prognosis remains poor, highlighting the urgent need to develop more effective treatment strategies. The controversy persists regarding the integration of a local therapy including surgery in the management of unresectable stage IV gastric cancer.
View Article and Find Full Text PDFAnn Surg Oncol
December 2024
Division of Hepatobiliary and Pancreatic Surgery, NYU Langone Health, NYU Grossman School of Medicine, New York, NY, USA.
Background: The National Comprehensive Cancer Network guidelines consider pancreatic cancer with celiac axis (CA), proper hepatic artery (PHA), and superior mesenteric artery (SMA) involvement unresectable. Thus, technical reports and video illustrations of these operations are rare. We report the stepwise management of multivascular reconstruction for Mayo Clinic class IIIb CA resections at New York University Langone Health, a dedicated center of excellence in pancreatic surgery.
View Article and Find Full Text PDFGan To Kagaku Ryoho
November 2024
Dept. of Gastroenterology Gastrointestinal Oncology, National Cancer Center Hospital East.
The standard first-line treatment for unresectable advanced or recurrent gastric cancer(GC)and gastroesophageal junction cancer(GEJC)has been a platinum doublet chemotherapy. Trastuzumab with chemotherapy is the standard regimen for HER2-positive GC/GEJC. While, for HER2-negative cases, chemotherapy with or without immune checkpoint inhibitors (ICIs)such as nivolumab or pembrolizumab are regarded as the standard therapy.
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