Abstract
A 62-year-old man undergoing an exploratory laparotomy for Stage IV (N4, S3, H3, P0, Borrmann 2 type, poorly differentiated) adenocarcinoma was treated by intensive chemotherapy consisting of etoposide 100 mg (days 3, 4, 5, i.v.), adriamycin 30 mg (days 1, 6, i.v.) and cis-platinum 50 mg (days 2, 7, i.v.) (EAP therapy). After this treatment, a marked reduction in the size of the primary, metastatic liver and lymph node tumors was observed by X-ray, endoscopy and CT. Upon reoperation 4 months after the initial laparotomy, partial gastrectomy, dissection of the metastatic lymph nodes and cannulation into the hepatic artery were performed. Almost all of the cancer cells in the primary tumor and lymph node metastases had dissappeared as a result of EAP therapy. This preoperative chemotherapy may be expected to increase resectability and possibly survival time.
