Safe use of capecitabine-cisplatin in metastatic gastric carcinoma with severe liver dysfunction: a case report from Algeria

Due to its high incidence and poor prognosis, gastric cancer is an important health problem worldwide. The liver is the most frequent site of metastases. Advanced cancer in the setting of liver dysfunction poses a dilemma for physicians, as many cancer chemotherapeutic agents undergo hepatic metabolism. This paper reports the case of a patient with liver failure due to liver metastases of gastric cancer. The initial liver function tests showed an elevation of transaminases (aspartate amino transferase 180 IU/l, alanine aminotransferase 110 UI/l), hyperbilirubinemia (total bilirubin at 24 mg/dl), alkaline phosphatase at 1127 UI/l and elevation of tumor markers (carcinoembryonic antigen >1000 ng/ml and CA19,9 at 180 UI/l). We initiated capecitabine/cisplatin based combination chemotherapy. Our data supports the safety and feasibility of cisplatin-capecitabine regimen in patients with severe liver dysfunction secondary to liver metastases of gastric cancer.