Abstract
We report a case of presently disease-free 5.5 year survival from metachronous metastatic liver tumors of alpha-fetoprotein (AFP)-producing gastric cancer treated by multidisciplinary therapies including three hepatectomies. A 62-year-old man had a medical examination, and upper gastrointestinal series and endoscopic examination revealed a type 0-IIa+IIc early gastric cancer in the lesser curvature, upper body of the stomach. Total gastrectomy with D1+β lymph node dissection was performed, and histological examination showed AFP-producing gastric cancer. Ten and 19 months after the operation, solitary liver tumors in segments 5 and 6, respectively, were detected, and partial liver resections were performed. Both of the specimens were diagnosed as metastases from the gastric cancer. Chemotherapy using S-1, PTX, CPT-11/CDDP were not sufficiently effective, and another recurrent liver tumor in segments 5–8 was pointed out. Radiofrequency ablation and transcatheter arterial embolization was performed and serum AFP level fell temporarily, but then increased again. The recurrent tumor also increased, and extended right lobectomy was performed 4 years after the first operation. After that, serum AFP level returned to a normal range, and the patient is presently alive with no recurrent tumor, five and a half years after the first operation.
