Carcinoma stomach: unwanted chemotherapeutic success: a case vignette

A 45-years-old male, chronic smoker and occasional alcoholic, from Tamenlong district of Manipur was admitted to the department of Surgery, RIMS, Imphal on 19(th) August, 2011. He was diagnosed as a case of poorly differentiated adenocarcinoma of the stomach located at incissura along the lesser curvature. CT scan of abdomen had revealed para-aortic, aorto-caval and celiac lymphadenopathy. Patient had undergone 5 cycles of neo-adjuvant chemotherapy consisting of 3 weekly course of Oxaloplatin 80mg(D1) + epirubicin 200mg (D1) + Capicitabine 2000mg(D1-D14). After 1 month of chemotherapy, patient then underwent subtotal gastrectomy (modified D2 resection) without any significant peri-operative complication. Surprisingly, the final histopathological report of the resected specimen didnx't reveal any evidence of malignancy in any sections. Role of chemotherapy in gastric cancers has been an adjunct to surgery and the optimal drugs regimen has not been elucidated so far. Till now, very few cases of carcinoma stomach which show pathological complete response have been reported. Our case is such a rare case of pathological complete response following neoadjuvant chemotherapy.