胃癌手术发现肝转移

胃癌手术发现肝转移

前2周，躺在加拿大多伦多某医院莫先生，原本是做胃癌切除手术，谁知外科医生打开一看，发现肝转移，手术无法进行。全家人非常担忧。回到家莫太太上网谷歌搜索，寻求美国医学专家会诊，美国希望之光医疗核心团队这行字醒目的出现在她眼前。抱着试一试的心情，立即拨通了美国希望之光医疗中心国际免费电话：95040351892

美国希望之光医疗中心得知莫先生的病情后，首席医务官极为重视，3天后安排了美国肿瘤专家戴教授和莫先生进行远程医疗视频会诊。

诊断：转移性胃癌

病史小结：

Middle age male with recently diagnosed distal gastric cancer (presumably adenocarcinoma), found to have hepatic metastasis during planned open distal gastrectomy which was aborted. Now has J-tube and feeding. Planned for palliative radiotherapy to gastric outlet obstruction, followed by ramucirumab, capecitabine, and cisplatin.

咨询建议：

1. Outlet obstruction- consider stenting by gastroenterologist.
2. Chemo- ramucirumab is approved for 2nd line therapy, would treat first with FOLFOX (add trastuzumab if HER2 positive), if progress, use ramucirumab plus paclitaxel as 2nd line, or look for clinical trial.
3. the clinical trial I mentioned is for HER2 negative patients, but there is no site in Canada. This immunotherapy trial is as following:

KEYNOTE-059  is recruiting patient like him, please contact following center to see if he is eligible and there is a spot for him:

https://clinicaltrials.gov/ct2/show/study/NCT02335411?term=pembrolizumab+gastric&rank=5&show_locs=Y#locn

4. if patient's biopsy sample is enough for more test, recommend immunohistochemistry staining for DNA mismatch enzyme expression. If expression is deficient, it's likely he will benefit from immunotherapy such as anti-PD1 (nivolumab or pembrolizumab, currently available only on clinical trial for gastric cancer).

美国希望之光医疗中心服务宗旨，即便远程医疗视频咨询后，您能继续通过我们团队与千里之外的美国医生保持联络，跟踪观察诊疗效果，让您足不出户，依旧能得到最贴心的后续关怀。