VEGF is a target molecule for peritoneal metastasis and malignant ascites in gastric cancer: prognostic significance of VEGF in ascites and efficacy of anti-VEGF monoclonal antibody
Our patient was a 62-year-old female diagnosed with type 4 gastric cancer, whose clinical course has been partially reported previously by our colleague. Exploratory laparoscopy revealed severe peritoneal metastasis with malignant ascites. The patient received two cycles of S-1 plus intraperitoneal docetaxel; disappearance of her peritoneal metastasis was confirmed by second-look laparoscopy. Subsequently, the patient underwent total gastrectomy with D2 lymph node dissection which completed an R0 resection. Eighteen months after surgery, the patient’s cancer recurred and was treated with four cycles of weekly paclitaxel, while the patient suffered from symptomatic ascites requiring frequent paracenteses. Because of lack of response, the patient was administered bevacizumab monotherapy (5 mg/kg) intravenously. Despite only one administration, the patient noted an improvement in abdominal distention and required no paracenteses. After bevacizumab therapy, the patient received eight cycles of weekly paclitaxel. She died of aspiration pneumonia due to ileus ().