TITLE:
Case Report: A Long Survivor Patient with Stage IV Gastric Adenocarcinoma
AUTHORS:
Marta Pina, Maria Leitão, Manuela Machado
KEYWORDS:
Gastric, Cancer, Metastatic Gastric Cancer, Palliative Surgery, Palliative Chemotherapy, Survival
JOURNAL NAME:
Journal of Cancer Therapy,
Vol.11 No.6,
May
29,
2020
ABSTRACT: Gastric cancer (GC) is the fifth most common malignancy of the world and
third leading cause of cancer death. At diagnosis, 35% of GC patients have
distant metastases and in these cases the survival rate is very poor with a
median overall survival (OS) inferior to 1 year. We report a case of a 67-year-old
woman with gastric carcinoma initially deemed limited stage on diagnosis
(cT2N0M0), treated surgically with radical subtotal gastrectomy with Billroth
II reconstruction. In the staging CT scan, the patient presented a liver image
that was considered benign. Three months later, due to abdominal pain, the
patient performed another CT scan and the diagnostic of a large single liver
metastasis was made; retrospectively it was observed that the lesion was
present at diagnosis and that it had increased. A biopsy was performed which
confirmed the metastatic origin. In a multidisciplinary team, the lesion was
considered unresectable. She was proposed for first line (1st L)
palliative chemotherapy (ChT) with FOLFIRI, with partial response as best
response. After 30 cycles of FOLFIRI, bone metastases were diagnosed. The
patient was submitted to a cementoplasty of D11-12 and L1-2. Afterwards, she
started 2nd L ChT with mFOLFOX6 and at the same time she started
zoledronic acid every 28 days. The best response to mFOLFOX6 was stable
disease. Since November 2018, the patient has been treated with zoledronic acid
every 28 days alone and maintains stable disease without ChT.