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SURGICAL TREATMENT OF REGIONAL RECURRENCE FROM GASTRIC CANCER AFTER MULTIMODAL TREATMENT WITH NEOADJUVANT CHEMORADIOTHERAPY (A CASE REPORT)

https://doi.org/10.21294/1814-4861-2018-17-2-104-110

Abstract

Background. Gastric cancer is the fourth most common cancer and the second leading cause of cancer-related death worldwide. Despite many advances in the diagnosis and treatment of gastric cancer, the overall five-year survival rate does not exceed 25–30 %, and distant metastases and loco-regional recurrence develop in more than 50 % of patients. Disease recurrence is not only associated with the presence of tumor micro-metastases at the time of surgery, but also with dissemination of tumor cells during mobilization of the stomach or lymph node dissection. Even after performing radical surgery, the prognosis remains extremely unfavorable. No standardized methods of treatment for isolated loco-regional recurrence have been developed yet. Cases of successful treatment of distant metastases and regional recurrence are sporadic. Case report. We present the case of a 75-year-old patient with histologically proven well-differentiated tubular adenocarcinoma of the stomach. The patient underwent neoadjuvant chemoradiation therapy (total radiotherapy dose was 45 Gy, modified Capox regimen) followed by gastrectomy and D2lymph node dissection. The control examination revealed an isolated regional recurrence of gastric cancer. It was decided to perform surgical treatment for isolated regional gastric cancer recurrence. Conclusion. There is no standardized approach to the treatment of regional recurrence of gastric cancer. Surgical treatment in such cases is a method of choice, especially for patients who previously received neoadjuvant chemoradiotherapy. According to the worldwide literature, the median survival of such patients does not exceed a few months. The key point that determines the effectiveness of neoadjuvant therapy is the achievement of complete or partial pathological response to therapy, thus demonstrating improved survival compared to surgery alone. Therefore, it is extremely important to search for immunohistochemical and molecular genetic markers for predicting tumor response to neoadjuvant therapy in order to administer it for only potential responders.

About the Authors

V. Yu. Skoropad
A. Tsyb Medical Radiological Research Centre – branch of the National Medical Research Radiological Centre of the Ministry of Health of the Russian Federation, Obninsk
Russian Federation

MD, DSc, Leading Researcher, A. Tsyb Medical Radiological Research Centre – branch of the National Medical Research Radiological Centre of the Ministry of Health of the Russian Federation (Obninsk, Russia)

Researcher ID: E-2200-2018



I. P. Kostyuk
A. Tsyb Medical Radiological Research Centre – branch of the National Medical Research Radiological Centre of the Ministry of Health of the Russian Federation, Obninsk
Russian Federation

MD, DSc, Deputy Director, A. Tsyb Medical Radiological Research Centre – branch of the National Medical Research Radiological Centre of the Ministry of Health of the Russian Federation (Obninsk, Russia)

Researcher ID: E-3158-2018

Author ID: 36710157000



L. V. Evdokimov
A. Tsyb Medical Radiological Research Centre – branch of the National Medical Research Radiological Centre of the Ministry of Health of the Russian Federation, Obninsk
Russian Federation

MD, PhD, A. Tsyb Medical Radiological Research Centre – branch of the National Medical Research Radiological Centre of the Ministry of Health of the Russian Federation (Obninsk, Russia)

Researcher ID: E-2309-201

Author ID: 750500



L. N. Titova
A. Tsyb Medical Radiological Research Centre – branch of the National Medical Research Radiological Centre of the Ministry of Health of the Russian Federation, Obninsk
Russian Federation
MD, PhD, A. Tsyb Medical Radiological Research Centre – branch of the National Medical Research Radiological Centre of the Ministry of Health of the Russian Federation (Obninsk, Russia)


D. D. Kudryavtsev
A. Tsyb Medical Radiological Research Centre – branch of the National Medical Research Radiological Centre of the Ministry of Health of the Russian Federation, Obninsk
Russian Federation

Researcher, A. Tsyb Medical Radiological Research Centre – branch of the National Medical Research Radiological Centre of the Ministry of Health of the Russian Federation (Obninsk, Russia)

Researcher ID: С-8505-2018



T. A. Agababian
A. Tsyb Medical Radiological Research Centre – branch of the National Medical Research Radiological Centre of the Ministry of Health of the Russian Federation, Obninsk
Russian Federation
MD, PhD, A. Tsyb Medical Radiological Research Centre – branch of the National Medical Research Radiological Centre of the Ministry of Health of the Russian Federation (Obninsk, Russia)


E. I. Kuprianova
A. Tsyb Medical Radiological Research Centre – branch of the National Medical Research Radiological Centre of the Ministry of Health of the Russian Federation, Obninsk
Russian Federation

MD, Pathologist, A. Tsyb Medical Radiological Research Centre – branch of the National Medical Research Radiological Centre of the Ministry of Health of the Russian Federation (Obninsk, Russia)

Researcher ID: Е-2368-2018



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Review

For citations:


Skoropad V.Yu., Kostyuk I.P., Evdokimov L.V., Titova L.N., Kudryavtsev D.D., Agababian T.A., Kuprianova E.I. SURGICAL TREATMENT OF REGIONAL RECURRENCE FROM GASTRIC CANCER AFTER MULTIMODAL TREATMENT WITH NEOADJUVANT CHEMORADIOTHERAPY (A CASE REPORT). Siberian journal of oncology. 2018;17(2):104-110. (In Russ.) https://doi.org/10.21294/1814-4861-2018-17-2-104-110

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ISSN 1814-4861 (Print)
ISSN 2312-3168 (Online)