Vietnamese and Japanese Doctors Save a Cambodian Man with a Critical Illness

A team of doctors from Japan and Vietnam has successfully performed surgery on a man suffering from advanced gastroesophageal junction cancer with liver metastasis who was previously unable to eat or drink.

1. Losing 14kg in One Month

Mr. P.H.L. (43 years old, Cambodian national) was diagnosed with advanced-stage gastroesophageal junction cancer with liver metastasis and underwent a multimodal treatment strategy combining systemic therapy and robotic surgery.

Specialist Doctor Level II Nguyễn Viết Hải from the Department of Gastroenterological Surgery at University of Medicine and Pharmacy Hospital 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 barely eat and could only consume water. Endoscopy and diagnostic imaging results revealed a large tumor in the cardia and esophagus, accompanied by liver metastatic lesions.

This represented an advanced stage of the disease with a challenging treatment prognosis, prompting doctors to prioritize systemic drug treatment prior to surgery.

Following multi-specialty consultations, the treatment team decided against immediate surgical tumor resection. Mr. L. underwent diagnostic laparoscopy, surgical removal of the liver metastatic lesion for biopsy, and gastrostomy tube placement to improve his nutritional status.

Subsequently, the patient received systemic treatment consisting of chemotherapy combined with targeted therapy (HER2-positive) and immunotherapy.

After 6 cycles, his condition improved markedly: Mr. L. resumed eating, gained weight, the tumor at the gastroesophageal junction shrank significantly, and no further metastatic lesions were found in the liver or elsewhere. Based on the patient's positive response to treatment, the professional board decided to proceed with surgery aiming for radical resection while preserving digestive function.

The procedure was performed using a robotic system with the collaboration of experts, including Professor Koichi Suda (Fujita Health University Hospital, Japan), Dr. Nguyễn Viết Hải, and Dr. Phan Văn Thái.

The doctors performed a subtotal gastrectomy rather than a total gastrectomy or esophagectomy. Because the tumor was located high up, with the esophageal resection margin situated approximately 6cm from the cardia, the anastomosis had to be performed within the thoracic cavity.

The team utilized the robotic system to approach through the right thoracic cavity, mobilize the esophagus, and execute the anastomosis with high precision—a complex technique requiring close coordination between abdominal and thoracic surgery.

Following surgery, Mr. L. was able to eat orally, walk independently, and experience a notable improvement in his general physical condition. Preserving the majority of the stomach and esophagus helps maintain digestive function, contributing to a better post-treatment quality of life for the patient.

2. Recommendation for Gastric Endoscopy Starting at Age 40

According to Assoc. Prof. Võ Duy Long, MD, PhD – Deputy Head of the Department of Gastroenterological Surgery, with the advancement of modern systemic treatments and robotic surgery, certain advanced cancer cases can still achieve favorable treatment outcomes if the correct strategy and intervention timing are chosen.

This case illustrates the role of multimodal treatment and domestic-international professional cooperation in enhancing treatment efficacy for patients.

Assoc. Prof. Võ Duy Long, MD, PhD, noted that the exact causes of gastroesophageal cancer remain undetermined. However, the disease shows a rising and younger-skewing trend due to various factors, such as regularly consuming long-fermented foods, smoked or grilled items, mold-contaminated foods; abusing alcohol and tobacco; living in polluted environments; and genetic predisposition.

In its early stages, the disease typically lacks specific symptoms and is easily mistaken for ordinary gastritis, gastroesophageal reflux disease, or mild throat obstruction.

To detect the disease early, doctors recommend that individuals undergo regular gastric endoscopy starting after the age of 40. If diagnosed at an early stage, the 5-year survival rate can reach up to 95%.

Source Link: https://vietnamnet.vn/cac-bac-si-viet-nam-nhat-ban-cuu-nguoi-dan-ong-campuchia-mac-benh-hiem-ngheo-2524508.html