A Case with Non-recurred Long Survival after Treatment of TS-1 for Post-Operative Peritoneal Recurrence from AFP-producing Gastric Carcinoma

Akinobu Matsuo, Masafumi Kuramoto, Satoshi Ikeshima, Imseung Choi, Tatsuhiko Sakamoto, Tetsuji Tashima, Hideo Baba* and Shinya Shimada

Department of Surgery, Yatsushiro Social Insurance General Hospital
Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University*

Gastric cancer patients suffering peritoneal recurrence are generally viewed as beyond help, especially those with AFP-producing gastric carcinoma. We report a case of chemotherapy for peritoneal dissemination from AFP-producing gastric carcinoma treated successfully. A 68-year-old man admitted for epigastralgia underwent distal gastrectomy on Nov., 2001 based on a diagnosis of suspicious AFP-producing gastric carcinoma resulting from a biochemical blood examination for elevated AFP. Pathological examination using immunohistochemistry confirmed that the tumor was AFP-producing gastric carcinoma and that final findings were T3, N1, H0, P0, CY0, Stage IIIA. Although serum AFP decreased postoperatively to the normal range, it rose again 13 months after surgery and CT and cytological examination showed peritoneal recurrence with ascites. Surprisingly, four courses of monochemotherapy using the administration of TS-1 100 mg/body/day led to complete remission of peritoneal dissemination. The man remains well without evidence of recurrence in the more than 4 years since surgery as evaluated by serum AFP, CT and PET.

Key words
AFP-producing gastric carcinoma, peritoneal dissemination, chemotherapy

Reprint requests
Akinobu Matsuo Department of Surgery, Yatsushiro Social Insurance General Hospital
2-26 Matsuejo, Yatsushiro, 866-8660 JAPAN

Accepted
April 23, 2008

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