A Case of Advanced Gastric Cancer with Liver Metastasis Resected following Combined TS-1 and CPT-11 Neoadjuvant Chemotherapy

A 63-year-old man was admitted for upper abdominal pain was found in endoscopic examination to have type 3 advanced gastric cancer in the lower stomach. Abdominal computed tomography and ultrasonography showed solitary 30mm liver metastasis in liver segment S4.We started neoadjuvant chemotherapy using TS-1 plus CPT-11.TS-1 (100mg/body weight/day) was orally administered for 3 weeks followed by a drug-free 2-week period, and CPT-11 (80mg/body weight) was administered intravenously on day 1 and 15 as 1 course. After 2 courses of chemotherapy, the liver metastasis shrank. Subsequent laparotomy found no liver metastasis in intraoperative ultrasonography, so we conducted distal gastrectomy with D2 lymph node cleaning, reconstruction by R-Y anastomosis, and cholecystectomy.TS-1 alone was continued for a year as adjuvant chemotherapy. No recurrence was seen in the 3 years after surgery. Initial treatment for advanced gastric cancer with resectable synchronous liver metastasis is generally surgery, but we conducted surgical treatment after neoadjuvant chemotherapy. This case suggests that neoadjuvant chemotherapy is effective against advanced gastric cancer with liver metastasis.