Abstract
Purpose : Chemotherapy was administered to patients with stomach cancer with Virchow's metastasis, and surgical resection of the stomach was performed in patients whose Virchow's metastasis had disappeared on computed tomography. These cases of excision were clinicopathologically investigated. Methods : From 2005 through 2012, four patients underwent surgical stomach removal after chemotherapy for stomach cancer with Virchow's metastasis. All cases were clinicopathologically examined. Results : Chemotherapy comprised mainly the fluoropyrimidine S-1 and was given for 6 to 11 months. Stomach resection was combined with lymph node dissection, including sampling of the para-aortic lymph nodes. Invasion was mucosal and submucosal, and no lymph node metastases were present in two of the four patients. These patients had no recurrence after the operation ; one survived for 4 years and 9 months, and the other survived for 8 months after the operation. In two patients, invasion was serosal and subserosal, and lymph node metastases were found pathologically ; both patients died of recurrence. One died 1 year after the operation, and the other died 8 months after the operation. Conclusion : In patients with stomach cancer and the disappearance of Virchow's metastasis on computed tomography after chemotherapy, we can expect long-term survival. Because cancer often persists at the original site even when it disappears from the lymph nodes, the original lesion should be surgically removed. When no lymph node metastases are found pathologically, long-term survival is possible, but an accumulation of future cases is necessary to verify this.
