Laparoscopic Gastrectomy for Gastric Cancer with Peritoneal Dissemination after Induction Chemotherapy
A 71-year-old man who suffered from abdominal pain was admitted to our hospital. Detailed examination included a CT scan, FDG PET-CT and a barium meal; the subsequent diagnosis was gastric cancer. We had planned to carry out TLTG, but when we inspected the abdominal cavity, ascites and peritoneal dissemination were evident. The patient was finally diagnosed with s stage IV (sT4aN3M0H0P1CY1) gastric cancer. 7 days after laparoscopic examination, S-1 (oral; 100 mg/day on days 1–21) combined with cisplatin (60 mg/m2 on day 8) were administered in three cycles as induction chemotherapy. After chemotherapy we performed a laparoscopic examination. No pathological dissemination was found during the operation. Thus, we judged that the cancer was resectable and undertook TLTG [, ]. The patient began food intake on the third day after surgery and was discharged without complications 10 days later. Adjuvant chemotherapy was begun 36 days after the operation. To date, we have followed up this patient for 14 months after surgery and cancer has not recurred.