What happened, in summary

A 34-year-old woman presented in September 2015 with upper-abdominal pain and a 13-kg weight loss. Endoscopy showed a large gastric tumor extending from the upper stomach toward the antrum, and biopsy confirmed poorly differentiated adenocarcinoma. CT and staging laparoscopy showed extensive peritoneal metastases with ascites, and cancer cells were present in the peritoneal fluid, establishing metastatic gastric cancer.

She received 6 cycles of combined systemic and intraperitoneal chemotherapy using the BISIC approach. Reassessment showed marked reduction in the gastric tumor, ascites and peritoneal disease, and repeat peritoneal cytology became negative. In June 2016, surgeons found no visible peritoneal lesions and proceeded with total gastrectomy, D2 lymph-node dissection and resection of previously involved peritoneal areas. HIPEC with cisplatin and docetaxel was given during surgery. Pathology found only a small amount of viable tumor, no involved lymph nodes among 38 removed, and no viable cancer in the resected peritoneal areas.

After recovery, she received 5 additional cycles of capecitabine. At the last follow-up in January 2018, she was asymptomatic and examinations showed no evidence of disease.