A Long-surviving（5 Years）Patient with HER2-positive/AFP-producing/Unresectable Advanced Gastric Cancer following Multidisciplinary Treatment

Abstract

AFP-producing gastric cancer is a rare gastric neoplasm metastasizing to the lymph nodes and the liver and having a poor prognosis. In this study, we report on a patient with HER2-positive/AFP-producing/unresectable advanced gastric cancer who achieved a long-term survival following multidisciplinary treatment including trastuzumab administration. The patient was a 64-year-old man. He had type 2 gastric cancer in the lesser curvature of the gastric angle, which was unresectable and had advanced with multiple liver metastases as well as multiple lymph node metastases including the periaortic lymph node. With elevated serum AFP levels, histopathology revealed AFP immunostaining positive and HER2 protein 3+ (IHC). After three courses of S-1/CDDP/trastuzumab, the hepatic metastases and lymphadenopathy were not indicated.
Elevated serum AFP levels and re-enlargement of the regional lymph nodes appeared four months following the start of the treatment. Although the primary tumor had shrunk, it was diagnosed as group four upon a biopsy. Distal gastrectomy was performed five months after the initial treatment. Adjuvant chemotherapy was performed. The patient has survived with no relapse as of five years following the initial treatment.