A Case Report of a Patient with a Long Survival after Aggressive and Effective Multimodal Treatment for Gastric Cancer with Synchronous Multiple Hepatic Metastases

A 60-year-old man seen for vertigo and tarry stool was found in blood tests to have anemia and high serum CEA. Gastrointestinal endoscopy and computed tomography showed type II gastric cancer with lymph node and multiple hepatic metastases, necessitating chemotherapy using low-dose 5-FU/cisplatin. After metastatic liver lesions and lymph nodes shrank dramatically, we conducted distal gastrectomy with D2 lymph node dissection and partial hepatic resection. Despite postoperative hepatic arterial infusion of 5-FU (5-FU HAI), a recurrent hepatic lesion appeared 1 year and 8 months postoperatively. Treatment with 5-FU HAI failed to shrink the lesion, necessitating partial hepatic resection. He remains alive with normal serum CEA and recurrence-free 7 and a half years after initial surgery. In cases of gastric cancer with hepatic metastases, long-term survival may be attained through aggressive, effective multimodal treatment. We therefore favor such multimodal treatment for gastric cancer with hepatic metastases.