Total neoadjuvant chemotherapy: a silver lining during the COVID pandemic for a patient with locally advanced diffuse distal gastric adenocarcinoma

P. Patil (Lead / Corresponding author), H. A. Clements, P. G. Ramkumar, S. Walsh, R. Petty

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)

Abstract

Perioperative oncological therapies resulting in pathological complete response (pCR) in diffuse-type distal gastric adenocarcinoma are extremely rare. We report a case of locally advanced (cT3 N2 M0) diffuse-type distal gastric adenocarcinoma treated with 'total neoadjuvant' FLOT (eight cycles), due to the COVID-19 pandemic, and laparoscopic radical subtotal gastrectomy with D2 lymphadenectomy. The patient demonstrated a progressive radiological response on positron emission tomography with 2-deoxy-2-[fluorine-18]fluoro-d-glucose integrated with computed tomography (18F-FDG PET-CT) and pCR in the resected specimen (ypT0 N0). As far as we are aware, this is the first case of pCR in locally advanced T3 N2 diffuse distal gastric cancer to be reported in the literature. It introduces a novel approach of total neoadjuvant chemotherapy with 18F-FDG PET-CT to assess response, combined with radical minimally invasive surgical management to provide optimal care for patients with gastric cancer.

Original languageEnglish
Pages (from-to)e197-e201
Number of pages5
JournalAnnals of the Royal College of Surgeons of England
Volume104
Issue number7
Early online date30 Nov 2021
DOIs
Publication statusPublished - Jul 2022

Keywords

  • Gastric cancer
  • Neoadjuvant chemotherapy
  • Pathological complete response

ASJC Scopus subject areas

  • General Medicine

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