A case of Stage IV gastric cancer in which a partial response was maintained for four years with multidisciplinary treatment

Abstract The patient was a 63-year-old man with Stage IV gastric cancer (cT3, cNX, cM1[LYN]). After chemotherapy with S-1 plus paclitaxel (PTX), a partial response was achieved, and distal gastrectomy was subsequently performed. During continued chemotherapy with S-1 plus PTX after surgery, enlarged lymph nodes (#16) were observed. Metastasis was detected and treated with radiation therapy. Ten months after the cervical and Virchow lymph node metastases were detected, lymph node dissection was performed. After the second surgery, chemotherapy with S-1 plus cisplatin (CDDP) was selected, but the regimen was changed to S-1 alone because of cerebral infarction. This treatment resulted in the maintenance of a partial response for one year. However, lymph node metastases around the right iliac artery and left cervix subsequently appeared, and lymph node dissection was performed. Since the metastatic lesions remained inside the left parotid gland, radiation therapy to the cervical region was performed again. However, the right inguinal and iliac lymph node metastases enlarged, and we again attempted to treat them with radiation therapy. The patient died due to peritoneal dissemination four years and two months after his first visit.