[Advanced Gastric Cancer with Virchow's Lymph Node Metastasis-A Long-Term Survival Case]

Area of Science:

• Oncology
• Gastroenterology

Background:

• Gastric cancer presents a significant global health challenge.
• Metastatic disease, particularly to lymph nodes like Virchow's node and para-aortic lymph nodes (PAN), indicates advanced stage and poorer prognosis.

Observation:

• A 36-year-old woman with type 3 gastric cancer presented with melena and confirmed Virchow's node and PAN metastases.
• Initial treatment involved S-1 and cisplatin (CDDP) combination chemotherapy.

Findings:

• Two courses of chemotherapy led to significant reduction in lymph node metastases.
• Following chemotherapy, a total gastrectomy with D2 plus PAN dissection was performed.
• Histopathology confirmed complete absence of cancer cells in the resected primary tumor and all lymph nodes.
• No further treatment was required for the Virchow's node metastasis.
• The patient received adjuvant S-1 chemotherapy for 2.5 years post-surgery.

Implications:

• This case demonstrates the potential for neoadjuvant chemotherapy followed by radical surgery to achieve long-term remission in advanced gastric cancer.
• The successful management of lymph node metastases without additional interventions suggests the efficacy of combined modality treatment.
• Long-term disease-free survival achieved in this patient offers hope and informs treatment strategies for gastric cancer with distant metastases.