[Long-term disease-free survival following multimodal treatment in a patient with curatively unresectable advanced gastric cancer with metachronous liver metastasis].

A case was a 57-year-old man. Despite a diagnosis of cStage IV gastric cancer (cN2, cH0, cM0, cT3 (SE), cP1), we preferentially performed a non-curative surgery to avoid stenosis or bleeding by tumor invasion. Since no evidence of peritoneal metastasis was found at surgery, distal gastrectomy with D2 lymph node dissection was performed, and lymph nodes anterior to the pancreatic head were sampled. The pathological diagnosis was pT3 (SE), pN2, sH0, pM1 (LYM), pStage IV. After the surgery, S-1 was administered. One year and 9 months later, a solitary metastasis was found in S6 of the liver, and the patient underwent radiofrequency ablation (RFA) followed by adjuvant S-1. Currently, 5 years and 10 months after the surgery, the patient is under follow-up, and remains alive with recurrence-free. We speculate that in the presence of N or M (LYM) factors for stage IV gastric cancer, surgery with lymphadenectomy, which does not prevent the completion of adjuvant chemotherapy, followed by multimodal treatments such as continued chemotherapy and RFA, led to the long-term survival.

[A case of metastatic bladder cancer occurring after surgery for differentiated gastric cancer controlled by combination therapy of paclitaxel/S-1].

A 70-year-old male visited the hospital with a complaint of stomachache. Hydronephrosis was observed in the right kidney, and further examination confirmed a diagnosis of metastatic cancer limited to the bladder and rectovesical pouch after surgery for differentiated gastric cancer. Chemotherapy using paclitaxel(PTX)/S-1 was initiated. One course included 14 days of administration of S-1 (100 mg/body) followed by a 7-day interval, and the administration of PTX (60 mg/body) on the 1st and 15th days. General malaise developed after 4 courses, the dose of S-1 was reduced (80 mg/body), and PTX was administered only on the 1st day. CT conducted 9 months after the start of chemotherapy revealed the disappearance of ascites, decreased thickness of the bladder wall, and reduced size of the tumor in the rectovesical pouch. No new distal metastasis or peritoneal metastatic nodule has been observed, and there has been no tendency toward exacerbation for one year after the initial diagnosis. PTX/S-1 was suggested to be an effective treatment for metastatic cancer limited to the bladder and rectovesical pouch after surgery for differentiated gastric cancer.