Abstract

OLIVEROS WILCHES, Ricardo; FACUNDO, Helena; BONILLA GONZALEZ, Carlos  and  SANCHEZ PEDRAZA, Ricardo. Case Report of Conversion Therapy in Stage IV Gastric Cancer. Rev Col Gastroenterol [online]. 2018, vol.33, n.1, pp.61-67. ISSN 0120-9957.  https://doi.org/10.22516/25007440.233.

We report the case of a 47-year-old patient initially diagnosed with a Krukenberg tumor, an adnexal lesion 10 cm in diameter and a 3 cm lesion in the gastric corpus. A biopsy showed a poorly differentiated adenocarcinoma with signet ring cells. Initial laparoscopy showed an index of peritoneal carcinomatosis of 24 which indicated chemotherapy with palliative intent (cisplatin and capecitabine). The patient improved significantly and underwent a total hysterectomy with salpingo-oophorectomy. Chemotherapy continued with excellent clinical response as evidenced in CT scans. Together with the patient’s family, it was decided that she should undergo surgery. A total gastrectomy with D2 lymphadenectomy with curative intent was performed. The patient continued to receive capecitabine and cisplatin for three more months until para-aortic lymph node involvement was demonstrated and it became necessary to restart chemotherapy with a new scheme using iriniotecan. The patient has completed 22 months after the initial diagnosis in very good and clinical condition without symptoms.

Keywords : Stage IV gastric cancer; conversion surgery.

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