A Case of Liver Metastasis From Gastric Cancer Resposive to Intra-arterial Chemoembolization With Degradable Starch Microspheres, Allowing Limited Resection

Masanori Kishibuchi, Toshio Yagyuu, Makoto Yamasaki, Masayoshi Yasui, Toshio Nishi, Katsuhiro Kawasaki, Eiji Yayoi and Takesada Mori

Department of Surgery, Kaizuka City Hospital

The prognosis of liver metastasis from gastric cancer is very poor, and no effective therapy has been established. We report a case of liver metastasis from gastric cancer that was successfully treated by intra-arterial chemoembolization using degradable starch microspheres (DSM), allowing limited resection to be performed.
A 61-year-old woman underwent distal gastrectomy for early gastric cancer without lymph node metastasis at 60 years of age. Eight months after the operation, she had a high carcinoembryonic antigen (CEA) level of 32ng/ml and abdominal CT revealed a giant metastasis to the medial segment of the liver. The tumor rapidly increased to 9cm in diameter. Because of it's size and rapid growth, curative resection of the liver tumor was considered difficult. Therefore, 3 cycles of intrahepatic arterial chemoembolization using DSM and mitomycin C were performed. This treatment was successful in reducing the tumor to 3cm in diameter, after which curative medial segmentectomy of the liver was performed. Histological examination showed that fibrotic tissue had almost completely replaced the tumor and few cancer cells remained. These findings suggest that chemoembolization using DSM can be effective for the treatment of hypervascular liver metastases from gastric cancer.

Key words
degradable starch microspheres, liver metastasis of gastric cancer, Intra-arterial chemoembolization

Reprint requests
Masanori Kishibuchi Department of Surgery, Kaizuka City Hospital 3-10-20 Hori, Kaizuka City, 565-0015 JAPAN

Accepted
February 23, 2000

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