A Case of Advanced Gastric Cancer with Carcinomatous Ascites Successfully Treated with Intraperitoneal Administration of CDDP and TS-1

Masakazu Fujii, Motonori Okino, Kentaro Fujioka, Katsuyuki Yamashita and Kimikazu Hamano*

Department of Surgery, Onoda City Hospital
First Department of Surgery, Yamaguchi University School of Medicine*

A 66-year-old man who had lost about 10 kg, and reported abdominal pain was found in CT of the abdomen to have much ascitic and paraaortic lymph node swelling. Digital examination showed a tumor at Douglas' pouch. Based on gastroscopy, the pathology was Group V and a diagnosis of type 5 advanced gastric cancer was given. He was diagnosed with peritonitis carcinomatosa. To control ascites, a reservoir was implanted in subcutaneous tissue. Following surgery, CDDP was administered at a dose of 100 mg/week for 3 weeks. This was combined with oral administration of TS-1 (each course consisting of 120 mg/day for 2 weeks, with one week of drug withdrawal). CEA was 3,316 ng/ml at peak, and decreased and ascites were vanished. Schnitzler's metastasis recognized by digital examination, and paraaortic lymph node metastasis disappeared. A gastroscopic examination indicated that the cancer had decreased. It was concluded that CR had been achieved and this condition was maintained for 22 months by ambulant chemotherapy without sacrificing high quality of life.

Key words
intraperitoneal administration, carcinomatous ascites, cisplatin

Reprint requests
Masakazu Fujii Department of Surgery, Onoda City Hospital
1863-1 Higashitakatomari, Onoda, 756-0094 JAPAN

Accepted
July 27, 2005

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