1.Current status and progress in gastric cancer with liver metastasis.
Chinese Medical Journal 2011;124(3):445-456
OBJECTIVEThis review discusses the current status and progress in studies on gastric cancer with liver metastasis (GCLM), involving the routes, subtypes, and prognosis of GCLM; the genes and molecules associated with metastasis; the feasibility and value of each imaging modality; and current treatment options.
DATA SOURCESThe data used in this review were mainly from Medline and PubMed published in English from 2005 to August 2010. The search terms were "gastric cancer" and "liver metastasis".
STUDY SELECTIONArticles regarding the characteristics, diagnostic modalities, and various therapeutic options of GCLM were selected.
RESULTSThe prognosis of GCLM is influenced by the clinicopathological characteristics of primary tumors, as well as the presence of liver metastases. Improved understanding of related genes and molecules will lead to the development of methods of early detection and targeted therapies. For the diagnosis of GCLM, each imaging modality has its relative benefits. There remains no consensus regarding therapeutic options.
CONCLUSIONSEarly detection and characterization of liver metastases is crucial for the prognosis of gastric cancer patients. Multidisciplinary team discussions are required to design optimal treatment strategies, which should be based on the clinicopathological characteristics of each patient.
Humans ; Liver Neoplasms ; diagnosis ; drug therapy ; secondary ; surgery ; Stomach Neoplasms ; complications ; diagnosis ; drug therapy ; surgery
2.Bone marrow metastasis of stomach cancer: a case report.
Chinese Journal of Oncology 2005;27(12):712-712
Adenocarcinoma
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pathology
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secondary
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surgery
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Adult
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Bone Marrow Neoplasms
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diagnosis
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secondary
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Female
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Humans
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Postoperative Period
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Stomach Neoplasms
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pathology
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surgery
3.A Case of Low-grade Fibromyxoid Sarcoma of the Colon.
Min KIM ; Tae Jun SONG ; Seung Dae KANG ; Jong Sik KANG ; Jin Suk KIM ; June Sung LEE ; Chul Nam KIM ; Han Seong KIM
The Korean Journal of Gastroenterology 2014;64(6):375-379
Low-grade fibromyxoid sarcoma is a slowly growing soft tissue neoplasm that shows benign histologic features but may have clinical course of malignant disease. It has been reported to occur in the thigh, inguinal area, axilla, shoulder, neck, perineum or buttock. However, there have been few cases of abdominal organ involvement. A 21-year-old woman presented with a large palpable abdominal mass. A 7x4 cm sized round soft tissue tumor at right upper quadrant area was identified by abdominopelvic CT scan. Percutaneous ultrasound-guided biopsy revealed features of spindle cell tumor. On exploration, the tumor originated from transvers colon and was attached to gastrocolic ligament, transverse mesocolon and stomach. The tumor could be dissected with transverse colectomy and partial gastrectomy. The excised tumor, measuring 7x5x5 cm, was well demarcated and appeared as an ovoid mass with firm and myxoid cut surface. She was diagnosed with low-grade fibromyxoid sarcoma arising from transverse colon, and is currently being followed-up without recurrence or metastasis.
Colon, Transverse
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Female
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Humans
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S100 Proteins/metabolism
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Sarcoma/*diagnosis/pathology/surgery
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Soft Tissue Neoplasms/*diagnosis/pathology/surgery
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Stomach Neoplasms/pathology/secondary
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Tomography, X-Ray Computed
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Young Adult
4.Adenocarcinoma of Lung Cancer with Solitary Metastasis to the Stomach.
The Korean Journal of Gastroenterology 2014;64(3):154-157
Although hematogenous metastasis of cancer to the gastrointestinal track is rare, it sometime has been reported in patients with malignant melanoma and breast cancer. However, it is extremely rare for lung cancer to metastasize to the stomach, not to mention solitary gastric metastasis. Herein, the authors report a case of a 69-year-old man who was initially diagnosed with lung cancer with synchronous primary gastric cancer which proved to be lung cancer with solitary gastric metastasis after the operation.
Adenocarcinoma/*diagnosis/pathology
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Aged
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Antineoplastic Combined Chemotherapy Protocols/therapeutic use
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Diagnosis, Differential
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Endoscopy, Digestive System
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Humans
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Lung Neoplasms/*diagnosis/drug therapy/pathology
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Male
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Stomach Neoplasms/*diagnosis/secondary/surgery
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Tomography, X-Ray Computed
5.Early Gastric Cancer with Cellulitis-like Skin Metastasis.
Yong Ho JANG ; Do Hyoung LIM ; Yo Han KIM ; Won Yong SUH ; Keon Woo PARK ; Il Han SONG ; Soon Il LEE
The Korean Journal of Gastroenterology 2014;63(1):39-41
Skin metastasis from internal carcinoma rarely occurs and it has an incidence of 0.7% to 9%. Although the prognosis of the skin metastases varies considerably depending on the type of the primary malignancy, presence of metastatic skin cancer usually implies a widespread systemic disease and a high mortality. A 50-year-old Korean male patient visited Dankook University Hospital for evaluation of skin rash on his whole abdomen of about 1 month's duration. He had undergone laparoscopy-assisted distal gastrectomy due to early gastric cancer about 3 months ago. He did not complain of any noticeable symptoms like febrile sense or pruritus. Skin biopsy was performed on the periumbilical area at previous port site and around the scar. Microscopic examination revealed multiple malignant cells in lymphatic spaces, consistent with metastatic carcinoma. He was therefore diagnosed with isolated skin metastasis from early gastic cancer. Because of patient's poor liver function, systemic chemotherapy could not be performed and only best supportive care was provided. Herein, we report a rare case of cellulitis-like skin metastasis from early gastric cancer with a brief review of the literature.
Carcinoma/*diagnosis/pathology/surgery
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Exanthema
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Humans
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Keratin-7/metabolism
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Laparoscopy
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Lymphatic Metastasis
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Male
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Middle Aged
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Neoplasm Staging
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Positron-Emission Tomography
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Skin Neoplasms/metabolism/pathology/secondary
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Stomach Neoplasms/*diagnosis/pathology/surgery
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Tomography, X-Ray Computed
6.Percutaneous Placement of Self-Expandable Metallic Stents in Patients with Obstructive Jaundice Secondary to Metastatic Gastric Cancer after Gastrectomy.
Hyun Pyo HONG ; Tae Seok SEO ; In Ho CHA ; Jung Rim YU ; Young Jae MOK ; Joo Hyeong OH ; Se Hwan KWON ; Sam Soo KIM ; Seung Kwon KIM
Korean Journal of Radiology 2013;14(5):789-796
OBJECTIVE: To evaluate the outcomes of patients undergoing percutaneous placements of a biliary stent for obstructive jaundice secondary to metastatic gastric cancer after gastrectomy. MATERIALS AND METHODS: Fifty patients (mean age, 62.4 years; range, 27-86 years) who underwent percutaneous placements of a biliary stent for obstructive jaundice secondary to metastatic gastric cancer after gastrectomy were included. The technical success rate, clinical success rate, complication rate, stent patency, patient survival and factors associated with stent patency were being evaluated. RESULTS: The median interval between the gastrectomy and stent placement was 23.1 months (range, 3.9-94.6 months). The 50 patients received a total of 65 stents without any major procedure-related complications. Technical success was achieved in all patients. The mean total serum bilirubin level, which had been 7.19 mg/dL +/- 6.8 before stent insertion, decreased to 4.58 mg/dL +/- 5.4 during the first week of follow-up (p < 0.001). Clinical success was achieved in 42 patients (84%). Percutaneous transhepatic biliary drainage catheters were removed from 45 patients (90%). Infectious complications were noted in two patients (4%), and stent malfunction occurred in seven patients (14%). The median stent patency was 233 +/- 99 days, and the median patient survival was 179 +/- 83 days. Total serum bilirubin level after stenting was an independent factor for stent patency (p = 0.009). CONCLUSION: Percutaneous transhepatic placement of a biliary stent for obstructive jaundice secondary to metastatic gastric cancer after gastrectomy is a technically feasible and clinically effective palliative procedure.
Adult
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Aged
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Aged, 80 and over
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Bile Duct Neoplasms/complications/secondary/*surgery
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Bile Ducts, Extrahepatic/*surgery
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Female
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Follow-Up Studies
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Gastrectomy
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Humans
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Jaundice, Obstructive/diagnosis/etiology/*surgery
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Male
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Middle Aged
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Prosthesis Design
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Retrospective Studies
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*Stents
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Stomach Neoplasms/*complications/secondary/surgery
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Treatment Outcome
7.The Clinical Value of 18F-Fluorodeoxyglucose Uptake on Positron Emission Tomography/Computed Tomography for Predicting Regional Lymph Node Metastasis and Non-curative Surgery in Primary Gastric Carcinoma.
Ju Young CHOI ; Ki Nam SHIM ; Seong Eun KIM ; Hye Kyung JUNG ; Sung Ae JUNG ; Kwon YOO
The Korean Journal of Gastroenterology 2014;64(6):340-347
BACKGROUND/AIMS: Accurate preoperative detection of regional lymph nodes and evaluation of tumor resectability is critical to determining the most adequate therapy for gastric cancer. The aim of this study is to identify a possible link between 18F-fluorodeoxyglucose (18F-FDG) uptake on PET scan combined with CT scan (PET/CT) and predictions of lymph node metastasis and non-curative surgery. METHODS: This study included 156 gastric cancer patients who underwent preoperative 18F-FDG PET/CT and surgery. In cases with perceptible FDG uptake in the primary tumor or lymph nodes, the maximum standardized uptake value (SUVmax) was calculated. RESULTS: In multivariate analysis, non-curative surgery (OR, 11.05; 95% CI, 1.10-111.08; p=0.041), tumor size (> or =3 cm) (OR, 7.39; 95% CI, 2.41-22.70; p<0.001), and lymph node metastasis (OR, 5.47; 95% CI, 2.05-14.64; p=0.001) were significant independent predictors for 18F-FDG uptake in the primary tumors. Tumor size (tumor size > or =3 cm) (OR, 3.15; 95% CI, 1.16-8.58; p=0.025) and lymph node metastasis (OR, 3.36; 95% CI, 1.23-9.14; p=0.018) showed significant association with 18F-FDG uptake in lymph node. When the SUVmax of the primary gastric tumor was greater than 3.75, the sensitivity and specificity of PET/CT with regard to the diagnosis of metastatic lymph node were 73.5% and 74.5%. When the SUVmax of the primary gastric tumor was greater than 4.35 and the FDG uptake of lymph nodes was positive, non-curative surgery was predicted with a sensitivity of 58.8% and specificity of 91.6%. CONCLUSIONS: A high FDG uptake of the gastric tumor was related to histologic positive lymph nodes and non-curative surgery.
Adult
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Aged
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Aged, 80 and over
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Area Under Curve
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Carcinoma/*diagnosis/pathology/surgery
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Female
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Fluorodeoxyglucose F18
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Humans
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Lymph Nodes/surgery
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Lymphatic Metastasis/radionuclide imaging
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Male
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Middle Aged
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Neoplasm Staging
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Odds Ratio
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Peritoneal Neoplasms/diagnosis/secondary
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Positron-Emission Tomography
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ROC Curve
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Regression Analysis
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Stomach Neoplasms/*diagnosis/pathology/surgery
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Tomography, X-Ray Computed
8.A Case of Hepatic Metastasis of Gastric Hepatoid Adenocarcinoma Mistaken for Primary Hepatocellular Carcinoma.
Ji Yoon MOON ; Gwang Ha KIM ; Jae Hoon CHEONG ; Bong Eun LEE ; Dong Yup RYU ; Geun Am SONG
The Korean Journal of Gastroenterology 2012;60(4):262-266
Gastric hepatoid adenocarcinoma is a special type of gastric carcinoma, which produces AFP. We report a case of an metastatic gastric hepatoid adenocarcinoma mistaken for primary hepatocellular carcinoma (HCC). A 72 year-old woman was transferred to our hospital for treatment of the hepatic mass. She underwent subtotal gastrectomy for gastric cancer 2 years ago. A year ago, she was diagnosed with hepatic mass and treated with transhepatic chemoembolization under the suspicion of primary HCC in other hospital. The hepatic mass looked like primary HCC on CT, and serum AFP was elevated to 18,735 IU/mL. We did the transhepatic mass biopsy and compared it to the histology of the previous gastric cancer. The results of immunohistochemical staining between them was coincident, and so it was diagnosed as a hepatic metastasis of gastric hepatoid adenocarcinoma.
Adenocarcinoma/*diagnosis/pathology/surgery
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Aged
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Carcinoma, Hepatocellular/*diagnosis/therapy
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Embolization, Therapeutic
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Endoscopy, Gastrointestinal
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Homeodomain Proteins/metabolism
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Humans
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Keratin-20/metabolism
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Keratin-7/metabolism
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Liver Neoplasms/diagnosis/*secondary/therapy
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Male
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Stomach Neoplasms/*diagnosis/pathology/surgery
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Tomography, X-Ray Computed
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alpha-Fetoproteins/analysis
9.A Case of Hepatic Metastasis of Gastric Hepatoid Adenocarcinoma Mistaken for Primary Hepatocellular Carcinoma.
Ji Yoon MOON ; Gwang Ha KIM ; Jae Hoon CHEONG ; Bong Eun LEE ; Dong Yup RYU ; Geun Am SONG
The Korean Journal of Gastroenterology 2012;60(4):262-266
Gastric hepatoid adenocarcinoma is a special type of gastric carcinoma, which produces AFP. We report a case of an metastatic gastric hepatoid adenocarcinoma mistaken for primary hepatocellular carcinoma (HCC). A 72 year-old woman was transferred to our hospital for treatment of the hepatic mass. She underwent subtotal gastrectomy for gastric cancer 2 years ago. A year ago, she was diagnosed with hepatic mass and treated with transhepatic chemoembolization under the suspicion of primary HCC in other hospital. The hepatic mass looked like primary HCC on CT, and serum AFP was elevated to 18,735 IU/mL. We did the transhepatic mass biopsy and compared it to the histology of the previous gastric cancer. The results of immunohistochemical staining between them was coincident, and so it was diagnosed as a hepatic metastasis of gastric hepatoid adenocarcinoma.
Adenocarcinoma/*diagnosis/pathology/surgery
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Aged
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Carcinoma, Hepatocellular/*diagnosis/therapy
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Embolization, Therapeutic
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Endoscopy, Gastrointestinal
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Homeodomain Proteins/metabolism
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Humans
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Keratin-20/metabolism
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Keratin-7/metabolism
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Liver Neoplasms/diagnosis/*secondary/therapy
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Male
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Stomach Neoplasms/*diagnosis/pathology/surgery
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Tomography, X-Ray Computed
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alpha-Fetoproteins/analysis
10.Capecitabine and Oxaliplatin (XELOX) for the Treatment of Patients with Metastatic Gastric Cancer and Severe Liver Dysfunction.
Seung Jae HWANG ; Jong Won PARK ; Sehe Dong LEE ; Gyong Jung KIM ; Cheol Ho SIN ; Seung Hyun NAM ; Bong Seog KIM
The Korean Journal of Internal Medicine 2006;21(4):252-255
Gastric cancer patients with severe liver dysfunction secondary to hepatic metastases have limited treatment options. Most cytotoxic drugs have a narrow therapeutic index. Although both capecitabine and oxaliplatin have been well tolerated as single agents for patients with severe hepatic dysfunction, the combination of these drugs has not been investigated. We report here on a case of successful treatment of a patient suffering with severe liver dysfunction and metastatic gastric cancer; the patient was treated with a combination of capecitabine and oxaliplatin (XELOX). The initial bilirubin level of the patient was 10.9 mg/dL. After two cycles of treatment, his bilirubin level decreased to 2.1 mg/dL. He has experienced an excellent radiological response and he has received six cycles of XELOX chemotherapy. XELOX chemotherapy is feasible and it can be associated with positive outcomes for the patients suffering with metastatic gastric cancer and severe liver dysfunction.
Stomach Neoplasms/complications/*pathology/surgery
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Prodrugs
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Organoplatinum Compounds/*therapeutic use
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Middle Aged
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Male
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Liver Neoplasms/complications/*drug therapy/secondary
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Liver Function Tests
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Liver Failure/diagnosis/drug therapy/*etiology
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Humans
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Gastrectomy
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Follow-Up Studies
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Fluorouracil/*analogs & derivatives/therapeutic use
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Drug Therapy, Combination
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Deoxycytidine/*analogs & derivatives/therapeutic use
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Antineoplastic Agents/*therapeutic use
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Adenocarcinoma/complications/secondary/*therapy