Abstract

Bandhuphat Chakrabandhu1 *, Sirikan Yamada1 , ShunJi Kato2 , Nobutoshi Hagiwara2 and Thiraphat Chakrabandhu1

A 48-year-old Thai male with metastatic liver gastric adenocarcinoma achieved a complete pathological response after neoadjuvant chemotherapy. The patient underwent a esophagogastroduodenoscopy in October, 2008, which revealed a ten centimeter ulcerated tumor mass at his antrum with complete gastric outlet obstruction. The biopsy of his gastric ulcer showed high grade necrotic adenocarcinoma. Further workups with computed tomography staged his cancer as cT4bN1M1 P0 CYX H1. He received 12 cycles of neoadjuvant chemotherapy consisting of oxaliplatin and fluoropyrimidine. The follow up computerized tomography CT scan, showed a complete regression of liver metastasis. Afterwards, he underwent a subtotal gastrectomy with D2 lymph node dissection showing a complete pathological response (grade 3 according to Japanese Classification of Gastric Carcinoma 3rd English edition). Postoperatively, he received eight cycles of capecitabine. After a 43 month follow up period, there is no recurrent disease.