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Pathological Complete Response Achieved with XELOX Chemotherapy, HIPEC, and Anti-PD-1 Immunotherapy in Stage IV Gastric Adenocarcinoma with Peritoneal Metastasis: A Case Report and Review of the Literature

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Abstract

Background

The detection rates of early gastric cancer (GC) in China are approximately 20%; upon diagnosis, the majority of patients with GC are identified as having advanced stage disease, and in some cases, even metastatic advanced GC. Currently, the optimal treatment strategy for peritoneal metastasis (PM) in GC remains uncertain, and pathological complete response (pCR) is rare following conversion therapy.

Case presentation

This case report details the management of a 66-year-old patient diagnosed with advanced stage IVB (T4N2M1c) adenocarcinomas of the gastric cardia with PM who received multimodal therapy comprised of hyperthermic intraperitoneal chemotherapy (HIPEC), XELOX chemotherapy, and anti-programmed cell death-1 (PD-1) therapy followed by radical gastrectomy. Through the multimodal management, the patient attained PCR and experienced long-term survival.

Conclusion

The conversion therapy protocol combined with HIPEC, XELOX chemotherapy, and anti-PD-1 therapy and our scientific, accurate, full-course management strategy may be propagable for potentially curing patients with advanced GC with PM.

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Data Availability

No datasets were generated or analyzed during the current study.

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Funding

This study was financially supported by National Natural Science Foundation of China (NO. 82373014).

Author information

Author notes

  1. The first authors, Jiajie Zhou and Jie Wang, contributed equally to this work.

Authors and Affiliations

  1. Northern Jiangsu People’s Hospital , Clinical Teaching Hospital of Medical School, Nanjing University, Yangzhou, 225001, China

    Jiajie Zhou, Shuai Zhao & Daorong Wang

  2. Clinical Medical College, Yangzhou University, Yangzhou, 225001, China

    Jie Wang & Longhe Sun

  3. Northern Jiangsu People’s Hospital, Yangzhou, 225001, China

    Wei Wang, Qiannan Sun & Daorong Wang

  4. The Forth People’s Hospital of Taizhou, Taizhou, 225300, China

    Longhe Sun

  5. Yangzhou Key Laboratory of Basic and Clinical Transformation of Digestive and Metabolic Disease, Yangzhou, China

    Daorong Wang

Authors
  1. Jiajie Zhou
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  2. Jie Wang
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  3. Wei Wang
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Contributions

Conceptualization: Jiajie Zhou, Jie Wang, Daorong Wang. Writing: Jiajie Zhou, Jie Wang. Data research: Wei Wang, Longhe Sun, Shuai Zhao. Molecular analysis: Qiannan Sun.

Corresponding author

Correspondence to Daorong Wang.

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Written informed consent was obtained from the patient for publication of this report and the accompanying images, and the patient’s anonymity was upheld.

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Zhou, J., Wang, J., Wang, W. et al. Pathological Complete Response Achieved with XELOX Chemotherapy, HIPEC, and Anti-PD-1 Immunotherapy in Stage IV Gastric Adenocarcinoma with Peritoneal Metastasis: A Case Report and Review of the Literature. J Gastrointest Canc (2024). https://doi.org/10.1007/s12029-024-01056-0

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  • DOI: https://doi.org/10.1007/s12029-024-01056-0

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