Advanced Gastric Cancer with Long-Term Survival for over Ten Years: Report of a Case

Long-term survival is rare in patients with advanced gastric cancer because most of them die of tumor recurrence within two years after the curative surgery. Surgery continues to be the mainstay of treatment, although other nonsurgical treatments have been widely researched. We report a 58-year-old female patient with a scirrhous type advanced gastric cancer. She underwent a radical subtotal gastrectomy with Billroth Ⅱ anastomosis. The surgical specimen showed an extensive submucosal and subserosal spreading, and 9 of the 34 dissected lymph nodes were involved. Thereafter, she received adjuvant chemotherapy with fluorouracil, adriamycin and mitomycin-C. She had regular follow-up thereafter. Ten years and six months later, by esophagogastroduodenoscopy, the patient was found to have a new growth tumor with only a small mucosal defect at the cardia of the remnant stomach. The patient received total resection of the remnant stomach, and the findings of the resected specimen showed an advanced scirrhous adenocarcinoma invading the whole stomach layers and the esophagus. Of the 33 resected lymph nodes, 18 of them were found positive for adenocarcinoma. This is a rare case of a patient with scirrhous gastric cancer with long-term survival, and adjuvant chemotherapy may attribute to such a clinical presentation.