Long-term survival after pulmonary resections for multiple metastases from gastric cancer: A case report. (2018)

• Record Type: Journal Article
• Authors: Kojima, Hideaki; Isaka, Mitsuhiro; Takahashi, Shoji; Machida, Nozomu; Funai, Kazuhito; Ohde, Yasuhisa
• Is Part Of: International journal of surgery case reports. Volume 45(2018)
• Page Start: 87
• Page End: 90
• Publication Date: 2018
• Subjects: Gastric cancer -- Pulmonary metastasis -- Pulmonary resection -- Pulmonary metastasectomy; Surgery -- Periodicals; Surgical Procedures, Operative -- Periodicals; Surgery; Electronic journals; Periodicals; 617.005
• DOI: 10.1016/j.ijscr.2018.03.020
• Languages: English
• ISSNs: 2210-2612

Abstract

Highlights: We report a case of long-term survival after pulmonary resections for multiple metastases from gastric cancer. The prognosis of pulmonary resection for metastatic gastric cancer is poor even though solitary metastasis. Recently, however, cases of long-term survival have been reported. By contrast, long-term survival after pulmonary resections for multiple pulmonary metastases from gastric cancer is extremely rare. Our case suggests that pulmonary metastasectomy could be a therapeutic option even in patients involving multiple pulmonary metastases. Abstract: Introduction: The prognosis of pulmonary resection for metastatic gastric cancer is poor even though solitary metastasis. Long-term survival after pulmonary resections for multiple pulmonary metastases from gastric cancer is extremely rare. Case presentation: The patient was 67-year old man who underwent a distal gastrectomy for early gastric cancer. Wedge resections of the right upper and lower lobes and right lower lobectomy were performed for metastases from gastric cancer at 29 months and 55 months after the gastrectomy, respectively. As of 96 months after the first pulmonary metastasectomy, this patient continues to be recurrence-free. Discussion: Multiple pulmonary metastases after gastrectomy are not considered candidates for surgery. Although systemic chemotherapy is the standard therapy for metastatic gastric cancer, the prognosis is extremely poor. In this case with favorable prognostic factors, such as long disease-free intervals or absence of extrapulmonary metastasis, pulmonary metastasectomy could be a therapeutic option in patients despite the presence of multiple pulmonary metastases. Conclusions: Our case suggests that even in cases involving multiple pulmonary metastases, pulmonary metastasectomy might be an effective therapeutic option that can improve survival.