Spleen-preserving D2 subtotal distal resection of the stomach and corpocaudal resection of the pancreas after neoadjuvant induction chemotherapy and chemoradiotherapy: case report and literature review

Background. Stomach cancer is one of the most common cancers worldwide. Long-term treatment outcomes in patients with locally advanced gastric invasion to adjacent structures are poor. In clinical recommendations Ministry Health Russian Federation, it recommended treat these perioperative chemotherapy according FLOT scheme. The effectiveness neoadjuvant chemoradiotherapy studied many multicenter studies involving randomized trials. Case description. We present a case successful patient (?T4bN2M0 – IVA stage). received therapy (2 cycles scheme) followed by (total dose 46 Gy concurrent capecitabine and oxaliplatin). Neoadjuvant was well tolerated (grade 1 gastrointestinal hematological toxicity). underwent distal subtotal resection stomach D2 lymph node dissection pancreas preservation spleen. No postoperative complications were observed. Histological examination revealed complete pathological response primary tumor, including area earlier into pancreas; metastasis small omentum. alive no evidence disease 20 months after surgery. Conclusion. feasibility conducting safe multimodal organ-preserving surgery (?T4bN2M0) shown. effective resulted achievement pathologic response, which favorable prognostic factor.