[A case of unresectable cardiac gastric cancer patient who maintained a long-term QOL with chemotherapy and detention of metallic stent].

ABSTRACT

A case was a 66-year-old man. He visited our hospital for dysphagia, abdominal distention and body weight loss. He was underwent gastro-endoscopy and made a diagnosis of the advanced cardiac gastric cancer. The early esophageal and gastric cancer also detected. Furthermore, computed tomography was performed and detected multiple liver and spleen, para-aortic lymph-node metastases and the ascites (suspected for dissemination). We decided that curative resection was impossible. Therefore, we performed an abdominal puncture to remove the ascites and combination chemotherapy with S-1 and docetaxel. The combination therapy was effective. The main tumor and multiple metastatic lesions were reduced. But after six months, a tumor marker was increased. The anticancer drug was changed to S-1 and CDDP. After eight months from the first-line chemotherapy started, the stenosis was appeared at esophago-gastric junction. We performed balloon dilation, and a metallic stent was detention with gastroscopy and radiography at stenotic lesion. He improved swallowing and discharged from hospital. After eleven months from the first-line chemotherapy started, he was died of increased liver metastases and peritonitis carcinomatousa.