Long-term survival of a patient with liver metastases from clear cell gastric adenocarcinoma after multimodality treatment including interventional oncology techniques: case report.
Gastric cancer
Hepatic metastases
Interventional oncology
Liver resection
Multidisciplinary approach
Portal vein embolization
SIRT
TACE
Journal
BMC gastroenterology
ISSN: 1471-230X
Titre abrégé: BMC Gastroenterol
Pays: England
ID NLM: 100968547
Informations de publication
Date de publication:
07 Mar 2022
07 Mar 2022
Historique:
received:
17
04
2021
accepted:
11
02
2022
entrez:
8
3
2022
pubmed:
9
3
2022
medline:
11
3
2022
Statut:
epublish
Résumé
Gastric cancer (GC) is the fourth most common cancer and the third leading cancer-related cause of death worldwide since most patients are diagnosed at an advanced stage. The majority of GCs are adenocarcinomas (ACs), and the poorly characterized clear cell AC represents a unique subgroup of GCs and is an independent marker of poor prognosis. Even though the prognosis for patients with advanced GC is poor we present a report of a patient with long-term survival despite having liver metastases from clear cell gastric AC. A 45-year-old male with clear cell gastric AC underwent subtotal gastrectomy and postoperative chemoradiation. Only a year and a half after his initial treatment the disease spread to his liver. He received two lines of chemotherapy treatment within the next two years before a right hepatectomy was suggested. Due to an initially insufficient future liver remnant (FLR), transarterial chemoembolization (TACE) and portal vein embolization (PVE) were performed, which made the surgical procedure possible. Shortly after a disease progression in the remaining liver was detected. In the following three years the patient was treated with a carefully planned combination of systemic therapy and different interventional oncology techniques including selective internal radiation therapy (SIRT) and TACE. And as illustrated, an attentive, patient-tailored, multimodality treatment approach can sometimes greatly benefit our patients as he had an overall survival of 88 months despite the poor prognosis of his disease. To the best of our knowledge, this report is the first to describe a patient with liver metastases from clear cell gastric AC treated with interventional oncology techniques (PVE, TACE, and SIRT) in combination with other locoregional and systemic therapies thereby presenting that these interventional oncology techniques can be successfully integrated into long-term management of non-conventional liver tumors.
Sections du résumé
BACKGROUND
BACKGROUND
Gastric cancer (GC) is the fourth most common cancer and the third leading cancer-related cause of death worldwide since most patients are diagnosed at an advanced stage. The majority of GCs are adenocarcinomas (ACs), and the poorly characterized clear cell AC represents a unique subgroup of GCs and is an independent marker of poor prognosis. Even though the prognosis for patients with advanced GC is poor we present a report of a patient with long-term survival despite having liver metastases from clear cell gastric AC.
CASE PRESENTATION
METHODS
A 45-year-old male with clear cell gastric AC underwent subtotal gastrectomy and postoperative chemoradiation. Only a year and a half after his initial treatment the disease spread to his liver. He received two lines of chemotherapy treatment within the next two years before a right hepatectomy was suggested. Due to an initially insufficient future liver remnant (FLR), transarterial chemoembolization (TACE) and portal vein embolization (PVE) were performed, which made the surgical procedure possible. Shortly after a disease progression in the remaining liver was detected. In the following three years the patient was treated with a carefully planned combination of systemic therapy and different interventional oncology techniques including selective internal radiation therapy (SIRT) and TACE. And as illustrated, an attentive, patient-tailored, multimodality treatment approach can sometimes greatly benefit our patients as he had an overall survival of 88 months despite the poor prognosis of his disease.
CONCLUSION
CONCLUSIONS
To the best of our knowledge, this report is the first to describe a patient with liver metastases from clear cell gastric AC treated with interventional oncology techniques (PVE, TACE, and SIRT) in combination with other locoregional and systemic therapies thereby presenting that these interventional oncology techniques can be successfully integrated into long-term management of non-conventional liver tumors.
Identifiants
pubmed: 35255812
doi: 10.1186/s12876-022-02150-y
pii: 10.1186/s12876-022-02150-y
pmc: PMC8900438
doi:
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
103Informations de copyright
© 2022. The Author(s).
Références
Ann Oncol. 2016 Sep;27(suppl 5):v38-v49
pubmed: 27664260
Br J Surg. 2006 Sep;93(9):1091-8
pubmed: 16779884
J Clin Oncol. 2016 May 20;34(15):1723-31
pubmed: 26903575
Radiol Oncol. 2016 Nov 10;50(4):418-426
pubmed: 27904450
Histopathology. 2014 Jul;65(1):90-9
pubmed: 25032253
Lancet Oncol. 2017 Sep;18(9):1159-1171
pubmed: 28781171
J Visc Surg. 2012 Apr;149(2):e86-96
pubmed: 22504072
J Vasc Interv Radiol. 2014 Jul;25(7):1067-73
pubmed: 24837982
Ann Surg Oncol. 2011 May;18(5):1251-7
pubmed: 21069467
Cochrane Database Syst Rev. 2017 Aug 29;8:CD004064
pubmed: 28850174