What question did this study set out to answer?

To evaluate the effectiveness of multidisciplinary treatment in the radical resection of AFP-producing gastric cancer with portal vein tumor thrombosis.

April 30, 2026Open Access

A Case of AFP-Producing Gastric Cancer with Portal Vein Tumor Thrombosis That Was Radically Resected by Multidisciplinary Treatment

Key Points

To evaluate the effectiveness of multidisciplinary treatment in the radical resection of AFP-producing gastric cancer with portal vein tumor thrombosis.
Patient diagnosed with advanced gastric cancer with portal vein thrombus.
Received 6 courses of CapeOX and nivolumab, followed by 3 additional courses of Capecitabine and nivolumab.
Underwent radical resection including total gastrectomy and portal vein resection after multiple therapies.
Pathology confirmed tumor stage as ypStage IIB with no tumor cells found in the portal vein post-surgery.
Post-operative follow-up of one year showed no recurrence of cancer.

Abstract

症例は76歳の男性で，上部消化管内視鏡で食道胃接合部から胃角の隆起性病変を認め，生検でtub1，HER2陰性，PD-L1 CPS 5以上であった．血清alpha-fetoprotein（AFP）値の上昇を認め，CTで胃小彎側の腫瘍と左胃静脈，門脈，上腸間膜静脈へ腫瘍の進展を認めた．門脈腫瘍栓を伴う切除不能進行胃癌と診断し，CapeOX，nivolumab療法を6コース施行した．CTで腫瘍栓の縮小を認めたが残存病変を認め，PET-CTで同部位に集積を認めた．Capecitabine，nivolumab療法を3コース施行したが腫瘍栓は消失せず，開腹胃全摘術，門脈合併切除，右外腸骨静脈グラフト再建を施行した．病理診断はtub1，ypT4a，ypN0，ycM0，ypStage IIB，治療効果判定はGrade 2bで門脈に腫瘍細胞は認めなかった．術後1年が経過した現在，無再発生存中である．

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