COMBINATION CHEMOTHERAPY WITH METHOTREXATE AND 5-FLUOROURACIL AND SURGERY FOR ADVANCED GASTRIC-CANCER WITH LIVER AND LYMPH-NODE METASTASES - A CASE-REPORT

We report on a case of advanced gastric cancer with multiple liver met astasis and lymph node metastases in a 65-year-old Japanese man. He wa s treated with sequential intravenous administration of moderate-dose methotrexate 1 (MTX) and 5-fluorouracil (5-FU) preoperatively. After e leven cycles of the combination chemotherapy, the findings of liver an d lymph node metastases diminished dramatically and the tumor could be resected for a potential cure, using a total gastrectomy and combined hepatectomy. The resected specimen revealed a slightly elevated lesio n and a somewhat shallow ulceration due to chemotherapy. Histologicall y, there was an infiltration of poorly differentiated adenocarcinomas with medullary structure in the muscularis mucosae with fibrous change . The liver was metastasized, but there was no evidence-of lymph node metastasis. We believe that combination chemotherapy of MTX and 5-FU c an be effective against gastric cancer.