A Case of Relapsed Gastric Cancer with Abdominal Para-aortic Lymphnode Metastasis Effectively Treated with a Combination of FLP Therapy

Hiroshi Yabusaki, Atsushi Nashimoto and Otsuo Tanaka

Division of Surgery, Niigata Cancer Center Hospital

A 68-year-old man with type 2 gastric cancer in the lower third of the stomach was treated by subtotal gastrectomy with para-aortic lymph node dissection. Because histological examination demonstrated 9 lymph nodes positive for metastasis in the para-aortic region, FP therapy (CDDP 75 mg on day 1, 5-FU 750 mg on day 1∼5) was conducted before discharge. 5'-DFUR was taken for 8 months orally on an outpatient basis. Local recurrence was evaluated by computed tomography 2 years 10 months after the primary surgery, and partial resection of the transverse colon and the liver (S5) was performed. At 5 years 3 months after the primary surgery, para-aortic lymph node recurrence was evaluated. We treated the patient with a combination of FLP therapy (CDDP 75 mg drip i.v. on days 1 and 8, 5-FU 500 mg/24 hours i.v. continuous infusion daily from day 1 through day 8, and Leucovorin 30 mg i.v. daily from day 1 through day 8). After the second course of chemotherapy, the lesion completely disappeared (complete response), and the patient is still alive after 5 years 9 months from the surgery. The results suggest that this combination chemotherapy might be safe and effective for the treatment of highly advanced and relapsed gastric cancer, especially with lymph node metastasis.

Key words
relapsed gastric cancer, abdominal para-aortic lymph node metastasis, FLP combination therapy

Reprint requests
Hiroshi Yabusaki Division of Surgery, Niigata Cancer Center Hospital 2-15-3 Kawagishicho, Niigata, 951-8566 JAPAN

Accepted
January 26, 2000

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