The prognosis of patients affected by advanced gastric cancer who did not undergo non-curative resection is extremely poor. We report a case of a 26-year-old woman affected by gastric cancer with peritoneal carcinosis in whom surgical treatment was not considered. The patient was enrolled in the Italian phase II trial of cetuximab (Erbitux, Merck KGaA, Darmstadt, Germany), a monoclonal antibody, in combination with docetaxel and cisplatin chemotherapy. Restaging of the tumor showed progressive regression, so the patient underwent a total gastrectomy. The patient is alive, well and disease-free ten months after surgery. The good result achieved in this patient provides interesting prospects for chemotherapy combined with cetuximab, followed by surgery.
MaruyamaK.: The most important prognostic factors for gastric cancer patients: a study using univariate and multivariate analyses.Scand J Gastroenterol, 22(Suppl 133): 63–68, 1987.
2.
NakamuraK., UeyamaT., YaoT., XuanZ.X., AmbeK., AdachiY., YakeishiY., MatsukumaA., EnjojiM.: Pathology and prognosis of gastric carcinoma: findings in 10,000 patients who underwent primary gastrectomy.Cancer, 70: 1030–1037, 1992.
3.
MaruyamaK., OkabayashiK., KinoshitaT.: Progress in gastric cancer surgery in Japan and its limits of radicality.World J Surg, 11: 418–425, 1987.
4.
RoukosD.H., KappasA.M.: Perspectives in the treatment of gastric cancer.Nat Clin Pract Oncol, 2: 98–107, 2005.
5.
KelleyJ.R., DugganJ.M.: Gastric cancer epidemiology and risk factors.J Clin Epidemiol, 56: 1–9, 2003.
6.
PersianiR., D'UgoD., RauseiS., SermonetaD., BaroneC., PozzoC., RicciR., La TorreG., PicciocchiA.: Prognostic indicators in locally advanced gastric cancer (LAGC) treated with preoperative chemotherapy and D2-gastrectomy.J Surg Oncology, 89: 227–236, 2005.
7.
BeckerK., MuellerJ.D., SchulmacherC., OttK., FinkU., BuschR., BöttcherK., SiewertJ.R., HöflerH.: Histomorphology and grading of regression in gastric carcinoma treated with neoadjuvant chemotherapy.Cancer, 98: 1521–1530, 2003.
8.
PintoC., Di FabioF., BaroneC., SienaS., FalconeA., CascinuS., Rojas LlimpeF.L., ArtaleS., SchinzariG., GiaquintaS., MutriV., MartoniA.A.: Cetuximab in combination with cisplatin and docetaxel as first-line treatment in patients with locally advanced or metastatic gastric or gastroesophageal junction (GEJ) adenocarcinoma (Italian phase II DOCETUX study).J Clin Oncol, 26: 15S, 4575A, 2008.
9.
NCCN Gastric Cancer Panel Members: NCCN Clinical Practice Guidelines in Oncology™: Gastric Cancer. Available at http://www.nccn.org (V.2.2009) (accessed December 2009).
10.
CascinuS.: Linee Guida AIOM 2006.Neoplasie dello stomaco. Available at http://www.aiom.it (accessed December 2009).
11.
RoderJ.D., BöttcherK., SiewertJ.R., BuschR., HermanekP., MeyerH.J.: Prognostic factors in gastric carcinoma: results of the German Gastric Carcinoma Study 1992.Cancer, 72: 2089–2097, 1993.
12.
LeichmanL., SilbermanH., LeichmanC.G., SpearsC.P., RayM., MuggiaF.M., KiyabuM., RadinR., LaineL., StainS.: Preoperative systemic chemotherapy followed by adjuvant postoperative intraperitoneal therapy for gastric cancer: A University of Southern California pilot program.J Clin Oncol, 10: 1933–1942, 1992.
13.
AjaniJ.A., MayerR.J., OtaD.M., SteeleG.D., EvansD., RohM., SugarbakerD.J., DumasP., GrayC., VenaD.A.: Preoperative and postoperative combination chemotherapy for potentially resectable gastric carcinoma.J Natl Cancer Inst, 85: 1839–1844, 1993.
14.
WuA.W., XuG.W., WangH.Y., JiJ.F., TangJ.L.: Neoadjuvant chemotherapy versus none for respectable gastric cancer.Cochrane Database Syst Rev, 2: CD005047, 2007.
15.
PyrhönenS., KuitunenT., NyandotoP., KouriM.: Randomised comparison of fluorouracil, epidoxorubicin and methotrexate (FEMTX) plus supportive care with supportive care alone in patients with non-resectable gastric cancer.Br J Cancer, 71: 587–591, 1995.
16.
MuradA.M., SantiagoF.F., PetroianuA., RochaP.R., RodriguesM.A., RauschM.: Modified therapy with 5-fluorouracil, doxorubicin, and methotrexate in advanced gastric cancer.Cancer, 72: 37–41, 1993.
17.
GlimeliusB., HoffmanK., HaglundU., NyrénO., SjödénP.O.: Initial or delayed chemotherapy with best supportive care in advanced gastric cancer.Ann Oncol, 5: 189–190, 1994.
18.
Van CutsemE., Vande VeldeC., RothA., LordickF., KöhneC.H., CascinuS., AaproM;European Organisation for Research and Treatment of Cancer (EORTC)-gastrointestinal cancer group: Expert opinion on management of gastric and gastro-oesophageal junction adenocarcinoma on behalf of the European Organisation for Research and Treatment of Cancer (EORTC)-gastrointestinal cancer group.Eur J Cancer, 44: 182–194, 2008.
19.
Van CutsemE., MoiseyenkoV.M., TjulandinS., MajlisA., ConstenlaM., BoniC., RodriguesA., FodorM., ChaoY., VoznyiE., RisseM.L., AjaniJA;V325 Study Group: Phase III study of docetaxel and cisplatin plus fluorouracil compared with cisplatin and fluorouracil as first-line therapy for advanced gastric cancer: a report of the V325 Study Group.J Clin Oncol, 31: 4991–4997, 2006.
20.
CunninghamD., StarlingN., RaoS., IvesonT., NicolsonM., CoxonF., MiddletonG., DanielF., OatesJ., NormanA.R.: Upper Gastrointestinal Clinical Studies Group of the National Cancer Research Institute of the United Kingdom. Capecitabine and oxaliplatin for advanced esophagogastric cancer.N Engl J Med, 358: 36–46, 2008.
21.
YanoM., ShiozakiH., InoueM., TamuraS., DokiY., YasudaT., FujiwaraY., TsujinakaT., MondenM.: Neoadjuvant chemotherapy followed by salvage surgery: effect on survival of patients with primary noncurative gastric Cancer.World J Surg, 26: 1155–1159, 2002.
22.
WagnerA.D., GrotheW., HaertingJ., KleberG., GrotheyA., FleigW.E.: Chemotherapy in advanced gastric cancer: a systematic review and meta-analysis based on aggregate data.J Clin Oncol, 24: 2903–2909, 2006.
23.
PintoC., Di FabioF., SienaS., CascinuS., Rojas LlimpeF.L., CeccarelliC., MutriV., GiannettaL., GiaquintaS., FunaioliC., BerardiR., LongobardiC., PianaE., MartoniA.A.: Phase II study of cetuximab in combination with FOLFIRI in patients with untreated advanced gastric or gastroesophageal junction adenocarcinoma (FOLCETUX study).Ann Oncol, 18: 510–517, 2007.
24.
LordickF., LorenzenS., StollfussJ., Vehling-KaiserU., KullmannF., HentrichM., ZumschlingeR., DietzfelbingerH., ThoedtmannJ., HennigM., SeroneitT., BredenkampR., DuysterJ., PeschelC.: Phase II study of weekly oxaliplatin plus infusional fluorouracil and folinic acid (FUFOX regimen) as first-line treatment in metastatic gastric cancer.Br J Cancer, 93: 190–194, 2005.
