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Laparoscopic Radical Gastrectomy for Remnant Gastric Cancer
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[Long-Term Complete Response of Peritoneal Recurrence from Advanced Gastric Cancer Using CapeOx Therapy Following
Keiji Nishibeppu1, Shuhei Komatsu, Daisuke Ichikawa
1Division of Digestive Surgery, Dept. of Surgery, Kyoto Prefectural University of Medicine.
Abstract:
Since the national insurance to use oxaliplatin(L-OHP)for gastric cancer was approved in Japan, patients with advanced or recurrent gastric cancer have been treated by CapeOX therapy as one of the standard regimens. Here, we report a case of long-term complete response of peritoneal recurrence from advanced gastric cancer using CapeOx therapy following radical gastrectomy. The patient underwent total gastrectomy with curative intent for advanced gastric cancer with cytology positive, and received S-1 based adjuvant chemotherapy for 13 months. However, tumor marker elevation and peritoneal recurrence were detected by following examinations. The patient received capecitabine, which is a 5-FU prodrug, plus L-OHP therapy. Complete disappearance of peritoneal recurrence was confirmed under laparotomy after the 8th course. L-OHP-induced upregulationof thymidine phosphorylase(TP)was reported to enhance the effectiveness of capecitabine in vivo. CapeOX therapy was also an effective treatment strategy for recurrence following S-1 based chemotherapy.
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