Scirrhous
gastric cancer tends to disseminate to the peritoneum and retroperitoneum, where it induces
fibrosis.
Retroperitoneal fibrosis (RPF) frequently causes
acute renal failure due to
ureteral obstruction and it tends to make many of physicians hesitate to initiate systemic
chemotherapy. The present study reported the case of a 68-year-old man who was diagnosed with scirrhous
gastric cancer with peritoneal and retroperitoneal dissemination, causing
acute renal failure due to RPF. Before initiating systemic
chemotherapy, the patient became anuric and introduced
hemodialysis (HD). Although the patient's performance status was poor, there were no
contraindications, such as active
infection or severe complications, for systemic
chemotherapy. Weekly 5-FU/l LV (5-FU 600 mg/m2, l-LV 250 mg/m2 on days 1, 8, 15, 22, 29 and 36; 8 weeks/cycle) was selected as the feasible treatment for the patient. After
chemotherapy the patient opted to withdraw from HD and suffered from no severe toxicity. This indicates, retrospectively, that earlier systemic
chemotherapy administration prior to HD introduction may result in improvement of renal function and avoidance of HD.