Vietnamese and Japanese doctors save critically ill Cambodian man
A joint medical team of specialists from Japan and Vietnam has successfully performed surgery on a man suffering from liver metastasis who was unable to eat.
14kg Weight Loss in One Month Mr. P.H.L. (43 years old, Cambodian national) was diagnosed with advanced gastroesophageal junction cancer with liver metastasis. He underwent a multimodal treatment strategy combining systemic therapy and robotic surgery.
Specialist Level II Dr. Nguyễn Viết Hải from the Department of Gastrointestinal Surgery at University Medical Center Ho Chi Minh City stated that Mr. L. was admitted having lost 14kg in a single month, experiencing progressive dysphagia (difficulty swallowing) to the point where he could only consume liquids. Endoscopy and imaging diagnostics revealed a large tumor at the cardia-esophageal junction alongside liver metastatic lesions.
As this was an advanced-stage case with a challenging prognosis, doctors prioritized systemic medical therapy prior to surgery.
Following multidisciplinary tumor board consultations, the treatment team decided against immediate tumor resection. Mr. L. initially underwent diagnostic laparoscopy, resection of the liver metastatic lesion for biopsy, and placement of a feeding gastrostomy tube to improve his nutritional status.
Subsequently, the patient received systemic therapy consisting of chemotherapy combined with targeted therapy (HER2-positive) and immunotherapy.
After six cycles, his condition showed marked improvement: Mr. L. resumed oral intake, gained weight, experienced significant tumor shrinkage at the gastroesophageal junction, and showed no remaining metastatic lesions in the liver or other sites. Based on this positive treatment response, the professional council decided to proceed with curative surgery aimed at eradicating the disease while preserving digestive function.
The procedure was performed using a robotic surgical system through a collaborative effort among leading experts, including Professor Koichi Suda (Fujita Health University Hospital, Japan), Dr. Nguyễn Viết Hải, and Dr. Phan Văn Thái.
The surgical team performed a proximal gastrectomy rather than a total gastrectomy or esophagectomy. Because the tumor was located high up, with an esophageal resection margin approximately 6cm from the cardia, the anastomosis had to be constructed inside the thoracic cavity.
The team utilized the robotic system to access the right thoracic cavity, mobilize the esophagus, and execute the anastomosis with high precision—a complex technique requiring seamless coordination between abdominal and thoracic surgical approaches.
Postoperatively, Mr. L. was able to eat orally, walk independently, and demonstrated a clear recovery in general physical condition. Preserving the majority of the stomach and esophagus helps maintain normal digestive function and contributes to a better post-treatment quality of life.
Recommend Gastric Endoscopy Starting at Age 40 According to Assoc. Prof. Dr. Võ Duy Long – Deputy Head of the Department of Gastrointestinal Surgery, with the continuous advancement of modern systemic therapies and robotic surgery, certain advanced-stage cancer cases can still achieve favorable outcomes when the appropriate strategy and timing of intervention are chosen.
This case highlights the critical role of multimodal treatment and domestic-international professional collaboration in elevating therapeutic efficacy for patients.
Assoc. Prof. Dr. Võ Duy Long noted that the exact causes of gastroesophageal cancer remain undetermined. However, the condition is showing an upward trend and affecting younger populations due to factors such as frequent consumption of long-term fermented foods, smoked or grilled items, and mold-contaminated foods; abuse of alcohol and tobacco; living in polluted environments; and genetic predisposition.
In its early stages, the disease typically presents without specific symptoms, making it easily confused with common gastritis, gastroesophageal reflux disease (GERD), or mild swallowing discomfort.
To detect the disease early, specialists recommend routine gastric endoscopy starting after the age of 40. When diagnosed at an early stage, the 5-year survival rate can reach up to 95%.