Abstract
The prognosis in liver metastasis from AFP-producing gastric carcinoma is generally considered dismal. We report a case of successful chemotherapy for liver metastasis from AFP-producing gastric carcinoma. A 71-year-old woman referred diagnosed with gastric cancer was found in a preoperative biochemical blood examination to have elevated AFP. Under a diagnosis of suspicious AFP-producing gastric carcinoma, distal gastrectomy was conducted on May 11, 1998. Elevated blood AFP decreased to the normal range postoperatively and AFP production in the tumor was confirmed histologically. Five months after surgery, liver metastasis with tumor thrombi in the main portal vein was detected via elevated AFP. Because of tumor thrombi in the main portal vein, neither major hepatic resection nor TAE was indicated. We therefore undertook hepatic arterial injection chemotherapy using FAM (5-FU, ADM, MMC) with additional oral use of UFT. Liver metastasis by 91% during the first 4 months and tumor thrombi in the portal vein had completely disappeared 28 months after the beginning of treatment. All chemotherapy was discontinued 4 years ago, and the woman remains well 6 years after surgery. Liver metastasis remains 1% of the original size, suggesting almost complete remission of AFP-producing cancer.
