Published online Jan 7, 2018. doi: 10.3748/wjg.v24.i1.150
Peer-review started: October 31, 2017
First decision: November 8, 2017
Revised: November 18, 2017
Accepted: November 27, 2017
Article in press: November 27, 2017
Published online: January 7, 2018
Bone metastasis is a rare event in patients with gastric cancer, but pathologic fracture, paralysis, pain and hematological disorders associated with the bone metastasis may influence the quality of life. We report herein the case of a 53-year-old man who presented with primary remnant gastric cancer with bone metastasis. The patient requested further investigations after detection of a metastatic lesion in the 2nd lumbar vertebra during evaluation for back pain that had persisted for 3 mo. No other metastatic lesions were detected. He underwent total gastrectomy and palliative metastasectomy to aid in reduction of symptoms, and he received combination chemotherapy with tegafur (S-1) and cisplatin. The patient survived for about 60 mo after surgery. Currently, there is no treatment guideline for gastric cancer with bone metastasis, and we believe that gastrectomy plus metastasectomy may be an effective therapeutic option for improving quality of life and survival in patients with resectable primary gastric cancer and bone metastasis.
Core tip: Gastrectomy and metastasectomy may be an effective therapeutic option for improving quality of life and survival in selected gastric cancer patients with bone metastasis. Favorable factors, such as resectable solitary bone lesions, good performance status and normal serum carcinoembryonic antigen levels, should be utilized to stratify and select patients who will be good candidates for surgery.