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April 30, 2026The Japanese Journal of Gastroenterological Surgery0 citationsOpen Access

A Case of AFP-Producing Gastric Cancer with Portal Vein Tumor Thrombosis That Was Radically Resected by Multidisciplinary Treatment

YHYuya HibinoSKSatoshi KOBAYASHITTTakehiro Takagi

Key Points

  • To evaluate the effectiveness of multidisciplinary treatment in the radical resection of AFP-producing gastric cancer with portal vein tumor thrombosis.
  • Patient diagnosed with advanced gastric cancer with portal vein thrombus.
  • Received 6 courses of CapeOX and nivolumab, followed by 3 additional courses of Capecitabine and nivolumab.
  • Underwent radical resection including total gastrectomy and portal vein resection after multiple therapies.
  • Pathology confirmed tumor stage as ypStage IIB with no tumor cells found in the portal vein post-surgery.
  • Post-operative follow-up of one year showed no recurrence of cancer.

Abstract

症例は76歳の男性で,上部消化管内視鏡で食道胃接合部から胃角の隆起性病変を認め,生検でtub1,HER2陰性,PD-L1 CPS 5以上であった.血清alpha-fetoprotein(AFP)値の上昇を認め,CTで胃小彎側の腫瘍と左胃静脈,門脈,上腸間膜静脈へ腫瘍の進展を認めた.門脈腫瘍栓を伴う切除不能進行胃癌と診断し,CapeOX,nivolumab療法を6コース施行した.CTで腫瘍栓の縮小を認めたが残存病変を認め,PET-CTで同部位に集積を認めた.Capecitabine,nivolumab療法を3コース施行したが腫瘍栓は消失せず,開腹胃全摘術,門脈合併切除,右外腸骨静脈グラフト再建を施行した.病理診断はtub1,ypT4a,ypN0,ycM0,ypStage IIB,治療効果判定はGrade 2bで門脈に腫瘍細胞は認めなかった.術後1年が経過した現在,無再発生存中である.

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Cite This Study

Hibino et al. (2026) studied this question.

synapsesocial.com/papers/69f2f0e31e5f7920c6386e97https://doi.org/10.5833/jjgs.2024.0107
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