Extended total gastrectomy after nivolumab for unresectable multivisceral invasive gastric cancer
Background Chemotherapy has been considered the main treatment for stage IV gastric cancer (GC). However, advances in chemotherapy have provided new clinical approaches, permitting conversion surgery with the aim of R0 resection after resolving unresectability issues. Case presentation A 70-year-old...
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| Veröffentlicht in: | Surgical Case Reports 2020-11, Vol.6 (1), p.298-298, Article 298 |
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| creator | Toyota, Satoshi Naito, Hiroshi Motoyoshi, Saki Nakanishi, Ryota Oki, Eiji Orita, Hiroyuki Korenaga, Daisuke |
| description | Background
Chemotherapy has been considered the main treatment for stage IV gastric cancer (GC). However, advances in chemotherapy have provided new clinical approaches, permitting conversion surgery with the aim of R0 resection after resolving unresectability issues.
Case presentation
A 70-year-old man with gastric cancer invading the pancreatic tail and spleen and with periaortic lymph-node enlargement was admitted to our hospital. After 24 courses of nivolumab as third-line chemotherapy, periaortic lymph-node enlargement was resolved, and conversion surgery was planned. Intraoperatively, we found no peritoneal metastasis, but the distal pancreas, splenic hilum, and transverse colon were adhered to the gastric body. Therefore, we performed D2 total gastrectomy with distal pancreatosplenectomy and partial transverse colectomy. The pathological diagnosis was type III moderately differentiated tubular adenocarcinoma (tub2) with signet ring cells, stage ypT1b (SM), ly0, and v0. The pathological proximal and distal tumor margins were negative. One lymph-node metastasis was observed (No. 4d; 1/23). Postoperatively, no recurrence was observed over 7 months, without adjuvant chemotherapy.
Conclusions
Nivolumab may allow R0 resection in patients with unresectable gastric cancer. Conversion surgery should be considered even after third-line nivolumab treatment. |
| doi_str_mv | 10.1186/s40792-020-01040-3 |
| format | Article |
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Chemotherapy has been considered the main treatment for stage IV gastric cancer (GC). However, advances in chemotherapy have provided new clinical approaches, permitting conversion surgery with the aim of R0 resection after resolving unresectability issues.
Case presentation
A 70-year-old man with gastric cancer invading the pancreatic tail and spleen and with periaortic lymph-node enlargement was admitted to our hospital. After 24 courses of nivolumab as third-line chemotherapy, periaortic lymph-node enlargement was resolved, and conversion surgery was planned. Intraoperatively, we found no peritoneal metastasis, but the distal pancreas, splenic hilum, and transverse colon were adhered to the gastric body. Therefore, we performed D2 total gastrectomy with distal pancreatosplenectomy and partial transverse colectomy. The pathological diagnosis was type III moderately differentiated tubular adenocarcinoma (tub2) with signet ring cells, stage ypT1b (SM), ly0, and v0. The pathological proximal and distal tumor margins were negative. One lymph-node metastasis was observed (No. 4d; 1/23). Postoperatively, no recurrence was observed over 7 months, without adjuvant chemotherapy.
Conclusions
Nivolumab may allow R0 resection in patients with unresectable gastric cancer. Conversion surgery should be considered even after third-line nivolumab treatment.</description><identifier>ISSN: 2198-7793</identifier><identifier>EISSN: 2198-7793</identifier><identifier>DOI: 10.1186/s40792-020-01040-3</identifier><identifier>PMID: 33237443</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Adjuvant treatment ; Cancer ; Care and treatment ; Case Report ; Case reports ; Chemotherapy ; Development and progression ; Gastric cancer ; Immunotherapy ; Medicine ; Medicine & Public Health ; Metastasis ; Monoclonal antibodies ; Stomach cancer ; Surgery ; Targeted cancer therapy</subject><ispartof>Surgical Case Reports, 2020-11, Vol.6 (1), p.298-298, Article 298</ispartof><rights>The Author(s) 2020</rights><rights>COPYRIGHT 2020 Springer</rights><rights>The Author(s) 2020. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c538t-aa414b3d558bffb3282d2e44706c70b78be26a0b2ce9b3f3bae401f7181df2d63</citedby><cites>FETCH-LOGICAL-c538t-aa414b3d558bffb3282d2e44706c70b78be26a0b2ce9b3f3bae401f7181df2d63</cites><orcidid>0000-0001-9604-0637</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7688799/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7688799/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,724,777,781,861,882,27905,27906,41101,41469,42170,42538,51300,51557,53772,53774</link.rule.ids></links><search><creatorcontrib>Toyota, Satoshi</creatorcontrib><creatorcontrib>Naito, Hiroshi</creatorcontrib><creatorcontrib>Motoyoshi, Saki</creatorcontrib><creatorcontrib>Nakanishi, Ryota</creatorcontrib><creatorcontrib>Oki, Eiji</creatorcontrib><creatorcontrib>Orita, Hiroyuki</creatorcontrib><creatorcontrib>Korenaga, Daisuke</creatorcontrib><title>Extended total gastrectomy after nivolumab for unresectable multivisceral invasive gastric cancer</title><title>Surgical Case Reports</title><addtitle>surg case rep</addtitle><description>Background
Chemotherapy has been considered the main treatment for stage IV gastric cancer (GC). However, advances in chemotherapy have provided new clinical approaches, permitting conversion surgery with the aim of R0 resection after resolving unresectability issues.
Case presentation
A 70-year-old man with gastric cancer invading the pancreatic tail and spleen and with periaortic lymph-node enlargement was admitted to our hospital. After 24 courses of nivolumab as third-line chemotherapy, periaortic lymph-node enlargement was resolved, and conversion surgery was planned. Intraoperatively, we found no peritoneal metastasis, but the distal pancreas, splenic hilum, and transverse colon were adhered to the gastric body. Therefore, we performed D2 total gastrectomy with distal pancreatosplenectomy and partial transverse colectomy. The pathological diagnosis was type III moderately differentiated tubular adenocarcinoma (tub2) with signet ring cells, stage ypT1b (SM), ly0, and v0. The pathological proximal and distal tumor margins were negative. One lymph-node metastasis was observed (No. 4d; 1/23). Postoperatively, no recurrence was observed over 7 months, without adjuvant chemotherapy.
Conclusions
Nivolumab may allow R0 resection in patients with unresectable gastric cancer. Conversion surgery should be considered even after third-line nivolumab treatment.</description><subject>Adjuvant treatment</subject><subject>Cancer</subject><subject>Care and treatment</subject><subject>Case Report</subject><subject>Case reports</subject><subject>Chemotherapy</subject><subject>Development and progression</subject><subject>Gastric cancer</subject><subject>Immunotherapy</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Metastasis</subject><subject>Monoclonal antibodies</subject><subject>Stomach cancer</subject><subject>Surgery</subject><subject>Targeted cancer therapy</subject><issn>2198-7793</issn><issn>2198-7793</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><recordid>eNp9UUtrFjEUHUSxpfYPuBpw42baPCfJRiilaqHgRtchydx8pswkNckM9t-bzym-FpJFQs7jnsvputcYXWAsx8vCkFBkQAQNCCOGBvqsOyVYyUEIRZ__8T7pzku5RwhhTqRU-GV3QimhgjF62pmb7xXiBFNfUzVzfzClZnA1LY-98RVyH8OW5nUxtvcp92vMUBpu7Az9ss41bKE4yE0a4mZK2GD3CK53JjbkVffCm7nA-dN91n15f_P5-uNw9-nD7fXV3eA4lXUwhmFm6cS5tN5bSiSZCDAm0OgEskJaIKNBljhQlnpqDTCEvcAST55MIz3r3u2-D6tdYHIQa0ulH3JYTH7UyQT9NxLDV31ImxajlEKpZvD2ySCnbyuUqpfjavNsIqS1aMJGhhXjiDbqm3-o92nNsa3XWIJSzpUkjXWxsw5mBh2iT22ua2eCJbgUwYf2fzXyEWPBFG8CsgtcTqVk8L_SY6SPreu9dd1a1z9b18csdBeVRo4HyL-z_Ef1A1CUsH4</recordid><startdate>20201125</startdate><enddate>20201125</enddate><creator>Toyota, Satoshi</creator><creator>Naito, Hiroshi</creator><creator>Motoyoshi, Saki</creator><creator>Nakanishi, Ryota</creator><creator>Oki, Eiji</creator><creator>Orita, Hiroyuki</creator><creator>Korenaga, Daisuke</creator><general>Springer Berlin Heidelberg</general><general>Springer</general><general>Springer Nature B.V</general><scope>C6C</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IAO</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0001-9604-0637</orcidid></search><sort><creationdate>20201125</creationdate><title>Extended total gastrectomy after nivolumab for unresectable multivisceral invasive gastric cancer</title><author>Toyota, Satoshi ; Naito, Hiroshi ; Motoyoshi, Saki ; Nakanishi, Ryota ; Oki, Eiji ; Orita, Hiroyuki ; Korenaga, Daisuke</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c538t-aa414b3d558bffb3282d2e44706c70b78be26a0b2ce9b3f3bae401f7181df2d63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Adjuvant treatment</topic><topic>Cancer</topic><topic>Care and treatment</topic><topic>Case Report</topic><topic>Case reports</topic><topic>Chemotherapy</topic><topic>Development and progression</topic><topic>Gastric cancer</topic><topic>Immunotherapy</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Metastasis</topic><topic>Monoclonal antibodies</topic><topic>Stomach cancer</topic><topic>Surgery</topic><topic>Targeted cancer therapy</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Toyota, Satoshi</creatorcontrib><creatorcontrib>Naito, Hiroshi</creatorcontrib><creatorcontrib>Motoyoshi, Saki</creatorcontrib><creatorcontrib>Nakanishi, Ryota</creatorcontrib><creatorcontrib>Oki, Eiji</creatorcontrib><creatorcontrib>Orita, Hiroyuki</creatorcontrib><creatorcontrib>Korenaga, Daisuke</creatorcontrib><collection>Springer Nature OA Free Journals</collection><collection>CrossRef</collection><collection>Gale Academic OneFile</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Surgical Case Reports</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Toyota, Satoshi</au><au>Naito, Hiroshi</au><au>Motoyoshi, Saki</au><au>Nakanishi, Ryota</au><au>Oki, Eiji</au><au>Orita, Hiroyuki</au><au>Korenaga, Daisuke</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Extended total gastrectomy after nivolumab for unresectable multivisceral invasive gastric cancer</atitle><jtitle>Surgical Case Reports</jtitle><stitle>surg case rep</stitle><date>2020-11-25</date><risdate>2020</risdate><volume>6</volume><issue>1</issue><spage>298</spage><epage>298</epage><pages>298-298</pages><artnum>298</artnum><issn>2198-7793</issn><eissn>2198-7793</eissn><abstract>Background
Chemotherapy has been considered the main treatment for stage IV gastric cancer (GC). However, advances in chemotherapy have provided new clinical approaches, permitting conversion surgery with the aim of R0 resection after resolving unresectability issues.
Case presentation
A 70-year-old man with gastric cancer invading the pancreatic tail and spleen and with periaortic lymph-node enlargement was admitted to our hospital. After 24 courses of nivolumab as third-line chemotherapy, periaortic lymph-node enlargement was resolved, and conversion surgery was planned. Intraoperatively, we found no peritoneal metastasis, but the distal pancreas, splenic hilum, and transverse colon were adhered to the gastric body. Therefore, we performed D2 total gastrectomy with distal pancreatosplenectomy and partial transverse colectomy. The pathological diagnosis was type III moderately differentiated tubular adenocarcinoma (tub2) with signet ring cells, stage ypT1b (SM), ly0, and v0. The pathological proximal and distal tumor margins were negative. One lymph-node metastasis was observed (No. 4d; 1/23). Postoperatively, no recurrence was observed over 7 months, without adjuvant chemotherapy.
Conclusions
Nivolumab may allow R0 resection in patients with unresectable gastric cancer. Conversion surgery should be considered even after third-line nivolumab treatment.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>33237443</pmid><doi>10.1186/s40792-020-01040-3</doi><tpages>1</tpages><orcidid>https://orcid.org/0000-0001-9604-0637</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Adjuvant treatment Cancer Care and treatment Case Report Case reports Chemotherapy Development and progression Gastric cancer Immunotherapy Medicine Medicine & Public Health Metastasis Monoclonal antibodies Stomach cancer Surgery Targeted cancer therapy |
| title | Extended total gastrectomy after nivolumab for unresectable multivisceral invasive gastric cancer |
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