[A Case of Advanced Gastric Cancer with Peritoneal Dissemination after Gastrectomy Successfully Treated with...

In the latest Japanese gastric cancer treatment guidelines, paclitaxel(PTX)plus ramucirumab(RAM)was positioned as a second-line chemotherapy for advanced gastric cancer. We report a case of advanced gastric cancer with peritoneal dissemination after gastrectomy successfully treated with PTX plus RAM. A 68-year-old man underwent distal gastrectomy with D2 lymph node dissection. The pathological diagnosis was moderately differentiated tubular adenocarcinoma, pT4apN1 M0, CY0, Stage ⅢA. He was treated with postoperative adjuvant chemotherapy of S-1. Four months after surgery, peritoneal dissemination was observed, he received capecitabine plus oxaliplatin therapy. However, 5 months after surgery, peritoneal dissemination became progressive disease and PTX plus RAM commenced. During the course of treatment, proteinuria (Grade 2), lower limb edema(Grade 2)and neutropenia(Grade 4)were observed as adverse events, but continuation of this chemotherapy was feasible. The patient survived without progression for 18 months after the recurrence was detected.