Laparoscopic Gastrectomy for Gastric Cancer with Peritoneal Dissemination after Induction Chemotherapy
A 65-year-old man had stomach discomfort. He underwent a gastro fiberscope examination and was diagnosed with type 4 gastric cancer. He was admitted to our hospital and a detailed examination was carried out. The diagnosis was stage IV (T4aN0M0H0P1) gastric cancer. FDG PET-CT examination indicated possible peritoneal dissemination because of the presence of ascites. Staging laparoscopy revealed pathological peritoneal dissemination. S-1 (oral; 80 mg/m2 on days 1–21) combined with cisplatin (60 mg/m2 on day 8) was administered in two cycles as induction chemotherapy. After chemotherapy, dissemination had disappeared on imaging and we decided that the original tumor was resectable. We performed staging laparoscopy to confirm that the tumor was resectable and TLTG was carried out continuously []. The patient started to eat on the third day after the operation and was discharged without complications 10 days later. Adjuvant chemotherapy commenced 21 days after the operation. To date, we have followed up this patient for 10 months after surgery with no evidence of cancer recurrence.