Surgical resection of colorectal recurrence of gastric cancer more than 5 years after primary resection

Abstract

INTRODUCTIONIntestinal metastasis from gastric cancer is rare, although the most common cause of secondary neoplastic infiltration of the colon is gastric cancer. However, little data is available on recurrence or death in patients with gastric cancer surviving >5 years post-gastrectomy. Here we report two cases of lower intestinal metastasis from gastric cancer >5 years after primary resection and discuss with reference to the literature.PRESENTATION OF CASECase 1: A 61-year-old man with a history of total gastrectomy for gastric cancer 9 years earlier was referred to our hospital with constipation and abdominal distention. We diagnosed primary colon cancer and subsequently performed extended left hemicolectomy. Histological examination revealed poorly differentiated adenocarcinoma resembling the gastric tumor he had 9 years earlier. The patient refused postoperative adjuvant chemotherapy and remained alive with cancerous peritonitis and skin metastases as of 17 months later. Case 2: A 46-year-old woman with a history of total gastrectomy for gastric cancer 9 years earlier presented with constipation. She also had a history of Krukenberg tumor 3 years earlier. We diagnosed metastatic rectal cancer and subsequently performed low anterior resection and hysterectomy. Pathological examination revealed poorly differentiated tubular adenocarcinoma, resembling the gastric tumor. The patient remained alive without recurrence as of 17 months later.DISCUSSIONWe found 19 reported cases of patients with resection of colon metastases from gastric cancer. Median disease-free interval was 74 months.CONCLUSIONResection of late-onset colorectal recurrence from gastric cancer appears worthwhile for selected patients.

Gastric cancer with repeated metastasis in the colonic lumen: a case report and multi-surgical experience

“…Colonic metastasis of gastric cancer is rare and has been reported only occasionally in the literature [ Table 1 ]. 6 – 10 The characteristics of the case in this study were as follows: 1. The pathological diagnosis of specimens from the five surgeries was poorly differentiated adenocarcinoma containing components of signet ring cell carcinoma.…”

Solitary metastasis to the skin and colon from gastric cancer after curative gastrectomy and chemotherapy

“…In some cases, surgical resection is necessary to control severe symptoms and ameliorate the quality of patients’ life. [ 25 ] We considered the operation for the sake of relieving the symptoms of hematochezia and abdominal distention caused by lumen stenosis of colon and improving the quality of life as well. And with the development of molecular targeted therapies and immunotherapies, VEGFR-2 inhibitors and PD-1 antibodies could also provide a good choice for the treatment of gastric carcinoma with HER-2 negative status.…”

Long-term survival after surgical resection of locoregional gastric adenocarcinoma recurrence — a case report

“…Kong et al found the two-year cumulative survival rates to be significantly better for resection of the recurrence plus chemotherapy than for chemotherapy only (23.8% vs. 1.2%, p < 0.001) [2]. Other studies also report generally longer survival time when surgery is performed along with chemotherapy [5,6]. For any given patient, appropriateness of extensive resection should be assessed by a multidisciplinary assessment team.…”

“…Recurrent tumour develops in most cases and often makes gastric cancer incurable [2][3][4]. Recurrences after curative resection for gastric carcinoma have been categorised as locoregional recurrence, peritoneal recurrence, and distant (including haematogenous) metastasis [5]. Although there is no clear consensus on the treatment of choice for recur-rent gastric cancer, there have been a few reports on the relative effectiveness of surgical treatment in selected patients [6].…”