A Case of AFP Producing Gastric Cancer which responded to Pre-Operative Chemotherapy

Yasuhiro Yuasa, Hiroshi Okitsu, Yoko Yamamura, Hiromitsu Takizawa, Hisashi Ishikura, Toshihiro Ichimori, Masashi Ishikawa, Suguru Kimura and Akihiro Sakata

Department of Surgery, Tokushima Red Cross Hospital

A 66-year-old man followed up for chronic hepatitis B was found in Ultrasonography to have intraabdominal lymphadenopathy in February 2006. Autoscopy showed a 4 cm type 1 mass beneath the gastric cardia, which proved to be papillary adenocarcinoma. The tumor marker AFP was 333 ng/ml. We began chemotherapy based on a diagnosis of stage IV T2N3M0. The regimen was 60 mg of intravenous Docetaxel (TXT) once a week, plus oral of TS-1 120 mg/day and low-dose cisplatin (CDDP) at 10 mg/day 5 days/week for 2 weeks. PR was attained in imaging, and AFP dropped to 45 ng/ml. We conducted total gastrectomy. For the primary lesion, CR was obtained histopathologically and Grade 2 was attained in the lymph gland. Only one tumor was evident in the lymph gland, and AFP coloring was positive. We conducted adjuvant chemotherapy with TS-1 for 3 courses. The man remains without recurrence for 14 months.

Key words
AFP producing gastric cancer, lymph node metastasis, chemotherapy

Reprint requests
Yasuhiro Yuasa Department of Surgery, Tokushima Red Cross Hospital
103 Irinokuchi, Komatsushima-cho, Komatsushima, 773-8502 JAPAN

Accepted
June 27, 2007

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