2020 Volume 53 Issue 7 Pages 566-573
A 64-year-old man was given a diagnosis of type 2 gastric cancer at the antrum on medical examination. The patient received SOX chemotherapy for unresectable stage IV gastric cancer of no. 6 lymph node and multiple liver metastases with a largest diameter of 9 cm. After 10 courses of SOX, the objective response according to the response evaluation criteria in solid tumors was determined as a partial response; however, he could not continue receiving chemotherapy due to side effects. We discussed the treatment plan and decided to perform conversion surgery. First, we performed distal gastrectomy with D2 lymph node dissection with no incurable factors except for liver metastases. We performed anterior liver resection and S6 partial liver resection 2 months after gastrectomy as radical resection. The pathological findings revealed that the gastric cancer and no. 6 lymph node metastasis exhibited a pathological complete response (pCR). Moreover, pathological findings revealed that all three metastatic lesions of S8, S5, and S6 were detectable in the resected specimen exhibited pCR. We report this case of stage IV gastric cancer with lymph node and multiple liver metastases treated with conversion gastrectomy and hepatectomy after SOX chemotherapy, the pathological findings of which revealed primary gastric cancer, and lymph node and multiple liver metastases exhibited pCR.
