Complete response of liver metastatic gastric cancer after FOLFOX-4 chemotherapy regimen followed by salvage gastrectomy: A case report

Abstract

A 48-year-old Thai male with metastatic liver gastric adenocarcinoma achieved a complete pathological 
response after neoadjuvant chemotherapy. The patient underwent a esophagogastroduodenoscopy in 
October, 2008, which revealed a ten centimeter ulcerated tumor mass at his antrum with complete 
gastric outlet obstruction. The biopsy of his gastric ulcer showed high grade necrotic adenocarcinoma. 
Further workups with computed tomography staged his cancer as cT4bN1M1 P0 CYX H1. He received 
12 cycles of neoadjuvant chemotherapy consisting of oxaliplatin and fluoropyrimidine. The follow up 
computerized tomography CT scan, showed a complete regression of liver metastasis. Afterwards, he 
underwent a subtotal gastrectomy with D2 lymph node dissection showing a complete pathological 
response (grade 3 according to Japanese Classification of Gastric Carcinoma 3rd English edition). 
Postoperatively, he received eight cycles of capecitabine. After a 43 month follow up period, there is no 
recurrent disease.