Laparoscopic stomach‐partitioning gastrojejunostomy in preparation for distal gastrectomy and Billroth‐II reconstruction after neoadjuvant chemotherapy for advanced gastric cancer with gastric outlet obstruction: A case report

2019 ◽  
Vol 13 (3) ◽  
pp. 415-418
Author(s):  
Hiroyuki Ishida ◽  
Haruhiko Cho ◽  
Kazuhito Tsuchida ◽  
Haruna Onoyama ◽  
Yukio Maezawa
Keyword(s):  
Gastric Cancer ◽  
Case Report ◽  
Neoadjuvant Chemotherapy ◽  
Advanced Gastric Cancer ◽  
Gastric Outlet Obstruction ◽  
Distal Gastrectomy ◽  
Outlet Obstruction ◽  
Billroth Ii ◽  
Billroth Ii Reconstruction

scholarly journals Complete Response of Locally Advanced Gastric Cancer with Pancreatic Invasion and Gastric Outlet Obstruction after Neoadjuvant Chemotherapy with S-1 and Oxaliplatin

2020 ◽  
Vol 13 (2) ◽  
pp. 716-720
Author(s):  
Masato Kondo ◽  
Shogo Nishino ◽  
Daisuke Yamashita ◽  
Satoshi Kaihara
Keyword(s):  
Gastric Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Advanced Gastric Cancer ◽  
Gastric Outlet Obstruction ◽  
Pathological Complete Response ◽  
Locally Advanced ◽  
Outlet Obstruction ◽  
Complete Response ◽  
Locally Advanced Gastric Cancer ◽  
Pancreatic Invasion

The prognosis of locally advanced gastric cancer is poor even if radical gastrectomy with D2 lymphadenectomy is followed by adjuvant chemotherapy. Hence, neoadjuvant chemotherapy is performed to try to improve the prognosis, as it can significantly downstage the tumor and safely improve the R0 resection rate of patients. Herein, we report a case of locally advanced gastric cancer with pancreatic invasion and gastric outlet obstruction that showed a pathological complete response after neoadjuvant chemotherapy with S-1 and oxaliplatin (SOX). A 74-year-old man presented to our hospital with abdominal pain and pyloric stenosis. CT images revealed a cStage IVb, cT4b tumor in the pancreas, cN1, cM0. Therefore, we performed laparoscopic gastrojejunostomy, and the patient’s oral intake improved after surgery; we then administered neoadjuvant chemotherapy with SOX on postoperative day 18, without any surgical complications. After 3 courses of neoadjuvant chemotherapy, the patient underwent radical distal gastrectomy, thereby avoiding pancreatoduodenectomy. Histopathological examination of the resected sample revealed no residual cancer cells, indicating a pathological complete response. No recurrence has occurred for 1 year after surgery. Thus, neoadjuvant chemotherapy with SOX can help in tumor downstaging and may be a multipotent option for the treatment of locally advanced gastric cancer, such as cases with the invasion of other organs; this treatment can result in improved curability and avoid overinvasive surgery.

scholarly journals Laparoscopic or open distal gastrectomy after neoadjuvant chemotherapy for advanced gastric cancer: study protocol for a randomised phase II trial

BMJ Open ◽  
2018 ◽  
Vol 8 (8) ◽  
pp. e021633 ◽  
Author(s):  
Ziyu Li ◽  
Fei Shan ◽  
Xiangji Ying ◽  
Lianhai Zhang ◽  
Hui Ren ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Advanced Gastric Cancer ◽  
Phase Ii ◽  
Standard Treatment ◽  
Phase Ii Trial ◽  
Distal Gastrectomy ◽  
Sample Size Calculation ◽  
Cox Proportional Hazards Model ◽  
Open Distal Gastrectomy

IntroductionCurrent guidelines recommend open gastrectomy with D2 lymph node dissection and adjuvant chemotherapy as the standard treatment for advanced gastric cancer. However, the prognosis is not satisfactory. Perioperative chemotherapy has been proposed to improve survival. Although still in debate, the efficacy of laparoscopic distal gastrectomy (LDG) in patients with advanced gastric cancer has been demonstrated in a few trials. Therefore, LDG after neoadjuvant chemotherapy can be a candidate for future standard treatment on advanced distal gastric cancer. We propose a randomised phase II trial to compare LDG and open distal gastrectomy (ODG) after neoadjuvant chemotherapy for advanced gastric cancer.Methods and analysisTo test the efficacy and safety, a randomised, open-label, single-centre, phase II trial was designed to evaluate the non-inferiority of LDG compared with ODG after neoadjuvant chemotherapy, with 3-year recurrence-free survival as the primary endpoint. The chosen critical value of a non-inferiority margin was an increase of <8%. The study started in 2015 and enrolled 96 patients according to a prior sample size calculation. Intention-to-treat and per-protocol approach will be used for efficacy analysis, and as-treated analysis will be applied for safety analysis. The survival curves will be constructed as time-to-event plots using the Kaplan-Meier method and compared using log-rank tests and Cox proportional hazards model. All statistical analyses will be conducted in standard statistical software with a significance level of 0.05.Ethics and disseminationThis study was approved by the Peking University Cancer Hospital Ethics Committee. The results will be submitted for publication in peer-reviewed journals.Trial registration numberNCT02404753; Pre-results.

Effectiveness of laparoscopic stomach-partitioning gastrojejunostomy for patients with gastric outlet obstruction caused by advanced gastric cancer

2016 ◽  
Vol 31 (1) ◽  
pp. 359-367 ◽  
Author(s):  
Tsuyoshi Tanaka ◽  
Koichi Suda ◽  
Seiji Satoh ◽  
Yuichiro Kawamura ◽  
Kazuki Inaba ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Advanced Gastric Cancer ◽  
Gastric Outlet Obstruction ◽  
Outlet Obstruction
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