A case of long survival in Stage IV gastric carcinoma responding to combination treatment with paclitaxel and 5- fluorouracil followed by surgical resection

: A 62-year-old female with epigastric pain was diagnosed with Type 4 gastric cancer upon detailed examination. Abdominal computed tomography(CT)revealed metastasis to the paraaortic lymph node and ascites at pelvis, and aspiration cytology of the ascites through vagina was positive(CY1). The clinical stage was determined as T4(panc) N1H0P0CY1M1(LYM), cStageIV. Three courses of neoadjuvant chemotherapy combined with paclitaxel and 5-fluorouracil( FT therapy)were performed. FT therapy showed a substantial reduction of the size of metastatic lymph nodes by sequentialCT examination, which was evaluated as partial response. Surgical resection consisted of total gastrectomy, and D2 lymph node dissection was performed. Operative cytology of ascites proved negative. The pathologic effect on primary lesion and metastatic lymph nodes was diagnosed as Grade 2. Although the prognosis of gastric cancer with carcinomatous peritonitis is poor, we here reported a patient with StageIV gastric cancer who markedly responded to FT therapy, which made surgical resection possible with the anticipation of extended survival. FT therapy may be a useful method for a patient with StageIVgastric cancer.