Liu ZN, Wang YK, Li ZY. Neoadjuvant chemoradiotherapy followed by laparoscopic distal gastrectomy in advanced gastric cancer: A case report and review of literature. World J Clin Cases 2021; 9(11): 2542-2554 [PMID: 33889619 DOI: 10.12998/wjcc.v9.i11.2542]
Corresponding Author of This Article
Zi-Yu Li, MD, Professor, Department of Gastrointestinal Surgery, Peking University Cancer Hospital and Institute, No. 52 Fucheng Road, Haidian District, Beijing 100142, China. ziyu_li@hsc.pku.edu.cn
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Apr 16, 2021; 9(11): 2542-2554 Published online Apr 16, 2021. doi: 10.12998/wjcc.v9.i11.2542
Neoadjuvant chemoradiotherapy followed by laparoscopic distal gastrectomy in advanced gastric cancer: A case report and review of literature
Zi-Ning Liu, Yin-Kui Wang, Zi-Yu Li
Zi-Ning Liu, Yin-Kui Wang, Zi-Yu Li, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Gastrointestinal Cancer Center, Peking University Cancer Hospital & Institute, Beijing 100142, China
Author contributions: Li ZY, Wang YK, and Liu ZN determined the preoperative regimen and performed the operation; the postoperative follow-up was done by Wang YK; Liu ZN and Wang YK collected patient data, performed image processing, and composed the manuscript; and Liu ZN revised and provided recommendations for the manuscript; All authors read and approved the final manuscript. Liu ZN and Wang YK contributed equally to this work.
Supported byBeijing Municipal Health Commission, No. DFL20181103 and No. ZYLX201701.
Informed consent statement: Informed consent was obtained from the patient for the publication of this case report and any accompanying imaging and pathological data.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Zi-Yu Li, MD, Professor, Department of Gastrointestinal Surgery, Peking University Cancer Hospital and Institute, No. 52 Fucheng Road, Haidian District, Beijing 100142, China. ziyu_li@hsc.pku.edu.cn
Received: September 14, 2020 Peer-review started: September 14, 2020 First decision: November 23, 2020 Revised: December 3, 2020 Accepted: February 11, 2021 Article in press: February 11, 2021 Published online: April 16, 2021 Processing time: 200 Days and 11.3 Hours
Abstract
BACKGROUND
The laparoscopic technique has been widely applied for early gastric cancer, with the advantages of minimal invasion and quick recovery. However, there is no report about the safety and oncological outcome of laparoscopic gastrectomy with D2 lymph node dissection for patients after neoadjuvant chemoradiotherapy.
CASE SUMMARY
A 60-year-old man was diagnosed with advanced distal gastric cancer, cT4aN1M0 stage III. The neoadjuvant chemoradiotherapy was performed based on the regimen of gross tumor volume 50G y/25 f and clinical target volume 45 Gy/25 f, as well as concurrent S-1 60 mg Bid. Then laparoscopic distal gastrectomy with D2 lymph node dissection was undertaken successfully for him after achieving partial response evaluated by radiological examination. The patient recovered smoothly without moderate or severe postoperative complications. The postoperative pathological stage was ypT3N0M0 with American Joint Committee on Cancer tumor regression grade 1. He was still in good condition after 5 years of follow-up.
CONCLUSION
Neoadjuvant chemoradiotherapy followed by laparoscopic technique could be applicable and may achieve satisfactory oncological outcomes. Our finding requires further validation by cohort studies.
Core Tip: The radicalness for locally advanced gastric cancer depends on the completed R0 resection. Although perioperative treatment strategies have been widely used for patients to reinforce the treatment effect, the use of neoadjuvant chemoradiation is controversial, let alone whether the patients can benefit from minimally invasive surgery. We presented the first case treated by laparoscopic distal gastrectomy following neoadjuvant chemoradiation. The perioperative safety and short-term and long-term oncological outcomes in this patient are described in detail.
