A 70-year-old female was admitted to our hospital with high fever about 5 days before this writing, along with anemia and hyperglycemia. Upper gastrointestinal series and endoscopy revealed type 1 gastric cancer in the greater curvature. CT and MRI showed multiple liver metastasis in the right lobe. Distal partial gastrectomy with lymphadenectomy and cannulation of hepatic artery was performed. The pathological findings revealed moderately-differentiated adenocarcinoma, T2, N0, H1, M0, stage IV. The postoperative chemotherapy with S-1 (80 mg/day) was administered for 4 weeks followed by 1 week rest and CDDP (50 mg) administered once every 4 weeks by arterial infusion. Two months after operation the tumor marker values have become normal, and CT can hardly detect the metastatic liver tumors. At 8 months after operation, CT and MRI revealed complete disappearance of these tumors. Then, 12 months after operation, FDG-PET revealed no accumulation. Now, at 18 months, the CR stage has been maintained. Combined use of peroral S-1 and CDDP by arterial infusion is effective for multiple liver metastasis after gastrectomy in gastric cancer.

Adachi A, Uchiyama T, Uchisako H, Hashimoto H.

Dept. of Surgery, Iwakuni Medical Center.