Complete Response for More than 4 Years following Neoadjuvant FOLFOX and Cytoreductive Surgery with Hyperthermic Intraperitoneal Chemotherapy for a Patient with Advanced Gastric Cancer with Extensive Peritoneal Carcinomatosis.

Autor: Peixoto RD; Centro Oncológico Antônio Ermírio de Moraes, São Paulo, Brazil., de Sousa TT; Hospital Alemão Oswaldo Cruz, São Paulo, Brazil., Silva PAIA; Hospital Alemão Oswaldo Cruz, São Paulo, Brazil., de Meirelles LR; Hospital Sírio Libanês, São Paulo, Brazil., Teixeira CHA; Hospital Alemão Oswaldo Cruz, São Paulo, Brazil.
Jazyk: angličtina
Zdroj: Case reports in oncology [Case Rep Oncol] 2018 May 17; Vol. 11 (2), pp. 305-310. Date of Electronic Publication: 2018 May 17 (Print Publication: 2018).
DOI: 10.1159/000488978
Abstrakt: Background: Peritoneal carcinomatosis is usually a terminal disease with short median survival in patients with gastric cancer. Systemic FOLFOX is one of the most used regimens in the first-line treatment of metastatic gastric cancer. However, there is scarce evidence that cytoreductive surgery (CRS) and intraperitoneal heated chemotherapy (HIPEC) improves oncological outcomes of patients with advanced gastric cancer.
Methods: Herein we present a case of a young woman with advanced gastric cancer with omental and peritoneal metastases who achieved an excellent response after 6 months of FOLFOX followed by CRS and HIPEC.
Results: A 53-year-old woman was diagnosed with advanced gastric carcinoma, with extensive omental caking and several peritoneal implants measuring 2 cm at the largest diameter. The patient received mFOLFOX6 for 6 months with excellent clinical and radiographic response. She was then submitted to a D2 total gastrectomy followed by CRS and HIPEC with mitomycin. The final pathology report showed a focal adenocarcinoma in the stomach measuring 0.4 mm with no residual tumor in the peritoneum (ypT1ypN0). The patient has been well and disease free for more than 4 years.
Conclusion: While still controversial, CRS followed by HIPEC may be a curative therapeutic option for highly selected patients.
Databáze: MEDLINE
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