Long-term survival of patient with gastric cancer treated by S-1 + paclitaxel combination chemotherapy against multiple liver metastases after gastrectomy and adrenalectomy

The patient was a 74-year-old man whose chief complaint was epigastralgia. A detailed examination revealed a gastric cancer located from antrum to duodenal bulb with multiple liver metastases. Because of a difficulty with oral intake, we performed a distal gastrectomy at first. After the operation, a combination chemotherapy with S-1 and weekly paclitaxel was performed, and liver metastases were successfully disappeared after 4 courses of the regimen. A subsequent CT evaluation after 6 courses of the regimen revealed that liver metastases maintained the clinical complete response (cCR), but a right adrenal tumor was detected. We performed a right adrenalectomy after 13 months from gastrectomy, and a histopathological examination revealed that the adrenal tumor was a recurrent gastric cancer. After the second operation, only one course treatment of S-1 alone was performed because the patient rejected the chemotherapy. The patient is alive without a chemotherapy and maintained cCR for 75 months after the second operation.