A Case of Non-recurred Long-term Survival after Chemotherapy for Liver Metastasis of AFP-producing Gastric Carcinoma

Naoki Sakurai, Junichiro Yamauchi, Norimasa Fukushima, Hisashi Shibuma, Eiichi Ikeda and Shunichi Sasou*

Departments of Surgery, and Pathology*, Yamagata Prefectural Central Hospital

The prognosis in liver metastasis from AFP-producing gastric carcinoma is generally considered dismal. We report a case of successful chemotherapy for liver metastasis from AFP-producing gastric carcinoma. A 71-year-old woman referred diagnosed with gastric cancer was found in a preoperative biochemical blood examination to have elevated AFP. Under a diagnosis of suspicious AFP-producing gastric carcinoma, distal gastrectomy was conducted on May 11, 1998. Elevated blood AFP decreased to the normal range postoperatively and AFP production in the tumor was confirmed histologically. Five months after surgery, liver metastasis with tumor thrombi in the main portal vein was detected via elevated AFP. Because of tumor thrombi in the main portal vein, neither major hepatic resection nor TAE was indicated. We therefore undertook hepatic arterial injection chemotherapy using FAM (5-FU, ADM, MMC) with additional oral use of UFT. Liver metastasis by 91% during the first 4 months and tumor thrombi in the portal vein had completely disappeared 28 months after the beginning of treatment. All chemotherapy was discontinued 4 years ago, and the woman remains well 6 years after surgery. Liver metastasis remains 1% of the original size, suggesting almost complete remission of AFP-producing cancer.

Key words
AFP-producing gastric carcinoma, liver metastasis, tumor thrombi of portal vein

Reprint requests
Naoki Sakurai Department of Surgery, Yamagata Prefectural Central Hospital
1800 Aoyagi, Yamagata-city, 990-2292 JAPAN

Accepted
October 19, 2004

To read the PDF file you will need Abobe Reader installed on your computer.