Gastric cancer patients still need to continue treatment after surgery

A 53-year-old female patient with gastric cancer came to the hospital for treatment because of upper abdominal pain and "indigestion" symptoms that lasted for three months, accompanied by anorexia, occasional vomiting, and increasing frequency of vomiting.

The patient had rarely experienced indigestion before, and had lost 10 kg since the onset of the above symptoms. She felt bloating after meals, fatigue, and lack of energy. She had a history of smoking 20 cigarettes/day, but had quit smoking 4 years ago. She had a habit of drinking 30 g/day, had no history of medication, and had a history of appendectomy, hysterectomy, and varicose vein surgery.

Based on her medical history, the doctor believed that several manifestations supported the diagnosis of gastric cancer: this was the first time a patient over 50 years old had indigestion, and the patient also had loss of appetite, vomiting, and weight loss, accompanied by suspected symptoms and risk factors for gastric cancer (history of smoking and drinking).

So the doctor asked her to undergo a full blood test, blood biochemistry test, and upper gastrointestinal imaging test. The results showed that the patient was anemic, and the contrast examination results showed that the distal gastric cavity was narrowed, the stomach, duodenum, and proximal cavity were filled with contrast agent, but there was a filling defect in the gastric antrum, which are typical manifestations of gastric cancer. Upper gastrointestinal endoscopy showed that there was a tumor extending from the middle of the gastric body to the distant gastric antrum. The lesion was biopsied and diagnosed as moderately differentiated adenocarcinoma.

Therefore, chest and abdominal CT scans and other examinations are performed to determine the location and size of the primary tumor, whether it has spread, whether there is metastasis, and whether there is ascites, in order to determine the treatment plan.

Because the patient had symptoms of early obstruction, the examination showed a stenotic lesion in the distal stomach, and the antrum was thickened and pale. There was a ridge-like protrusion on the tumor, separating the antrum from the proximal stomach. The tumor had involved the entire antrum, so a partial gastrectomy was performed.

However, the prognosis of gastric cancer was still poor, and the patient's tumor was a moderately differentiated adenocarcinoma, which extensively invaded the submucosa and involved the lymph nodes of the left paraaxial part of the stomach. The doctor had repeatedly recommended chemotherapy to the patient, but the patient refused further treatment and died of metastatic disease nine months later.