{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T16:39:20Z","timestamp":1786639160462,"version":"build-2736575974"},"reference-count":17,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T00:00:00Z","timestamp":1786579200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:p>\n                    <jats:italic>De novo<\/jats:italic>\n                    gastric cancer after liver transplantation is clinically rare, and radical resection remains the only potentially curative treatment. However, post-transplant anatomical distortion and extensive intra-abdominal adhesions increase surgical complexity, while long-term immunosuppression elevates the risks of perioperative infection and organ dysfunction. Furthermore, chemotherapy and immune checkpoint inhibitors may precipitate graft rejection. We report a 68-year-old man who underwent liver transplantation 18\u202fyears earlier for HBV-related hepatocellular carcinoma (T1aN0M0), meeting the Milan criteria. Preoperatively, serum HBV DNA was 2.3\u202f\u00d7\u202f10\n                    <jats:sup>3<\/jats:sup>\n                    IU\/mL. He received entecavir and basiliximab induction, followed by early triple immunosuppression and long-term tacrolimus maintenance. During follow-up, HBV DNA remained undetectable, liver function was stable, and no transplant-related complications occurred. Eighteen years after transplantation, he presented with upper abdominal pain. Imaging and endoscopy demonstrated cT4N1M0 gastric adenocarcinoma of the antrum with hepatic parenchymal invasion. Following multidisciplinary discussion, laparoscopic D2 radical gastrectomy with Roux-en-Y reconstruction, partial hepatectomy, and ultra-tension-reducing abdominal wall closure were performed. The postoperative course was uneventful. This case suggests that multidisciplinary, standardized perioperative management can enable safe radical laparoscopic gastrectomy in selected liver transplant recipients.\n                  <\/jats:p>","DOI":"10.3389\/fmed.2026.1914424","type":"journal-article","created":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T16:07:51Z","timestamp":1786637271000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Laparoscopic radical gastrectomy for gastric cancer following liver transplantation: a report of a rare and complex case and a multidisciplinary management strategy"],"prefix":"10.3389","volume":"13","author":[{"given":"Ying","family":"Miao","sequence":"first","affiliation":[{"name":"Affiliated Hospital of Chengde Medical University","place":["Chengde, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enhong","family":"Zhao","sequence":"additional","affiliation":[{"name":"Affiliated Hospital of Chengde Medical University","place":["Chengde, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuai","family":"Zheng","sequence":"additional","affiliation":[{"name":"Affiliated Hospital of Chengde Medical University","place":["Chengde, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ji","family":"Yang","sequence":"additional","affiliation":[{"name":"Affiliated Hospital of Chengde Medical University","place":["Chengde, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ziyu","family":"Yue","sequence":"additional","affiliation":[{"name":"Affiliated Hospital of Chengde Medical University","place":["Chengde, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,13]]},"reference":[{"key":"ref1","first-page":"1108","article-title":"One case report of new primary lung adenocarcinoma after liver transplantation for hepatocellular carcinoma","volume":"40","author":"Wang","year":"2025","journal-title":"Clin Focus"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"4028","DOI":"10.21037\/tcr-19-1786","article-title":"Robotic surgical system completed radical gastrectomy for gastric cancer after liver transplantation: case report and systematic review","volume":"9","author":"Chen","year":"2020","journal-title":"Transl Cancer Res"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"101","DOI":"10.4174\/astr.2023.104.2.101","article-title":"Clinical outcomes of gastric cancer surgery after liver transplantation","volume":"104","author":"Kim","year":"2023","journal-title":"Ann Surg Treat Res"},{"key":"ref4","volume-title":"Clinical Characteristics of Gastric Mucosal Lesions and Newly Diagnosed Gastric Malignancies Following Liver Transplantation","author":"Zhai","year":"2022"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"e2666","DOI":"10.1097\/MD.0000000000002666","article-title":"Lessons 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transplantation","volume":"4","author":"Pedersen","year":"2014","journal-title":"J Clin Exp Hepatol"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"187","DOI":"10.1007\/s10120-007-0428-5","article-title":"Experience of gastric cancer in a patient who had received a living-donor liver transplantation","volume":"10","author":"Nagata","year":"2007","journal-title":"Gastric Cancer"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"111073","DOI":"10.4292\/wjgpt.v16.i4.111073","article-title":"Metabolic syndrome after liver transplantation: a silent threat to long-term success","volume":"16","author":"Chan","year":"2025","journal-title":"World J Gastrointest Pharmacol Ther"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"481","DOI":"10.1007\/s10120-023-01382-5","article-title":"Association between metabolic syndrome and gastric cancer risk: results from the health examinees study","volume":"26","author":"Huang","year":"2023","journal-title":"Gastric Cancer"},{"key":"ref12","first-page":"16","article-title":"The impact of laparoscopic radical gastrectomy and open surgery on postoperative gastrointestinal function and quality of life in patients with early-stage gastric cancer","volume":"4","author":"Cao","year":"2025","journal-title":"Res Chinese and Foreign Med"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"2442","DOI":"10.1111\/tri.14115","article-title":"Chemotherapy, targeted therapy and immunotherapy: which drugs can be safely used in the solid organ transplant recipients?","volume":"34","author":"Maggiore","year":"2021","journal-title":"Transpl Int"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"113","DOI":"10.1111\/j.1532-950X.2006.00122.x","article-title":"Use of capecitabine after renal allograft transplantation in dog erythrocyte antigen-matched dogs","volume":"35","author":"Schmiedt","year":"2006","journal-title":"Vet Surg"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"3084","DOI":"10.3748\/wjg.v29.i20.3084","article-title":"Metronomic capecitabine inhibits liver transplant rejection in rats by triggering recipients' T cell ferroptosis","volume":"29","author":"Wang","year":"2023","journal-title":"World J Gastroenterol"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"116","DOI":"10.1016\/j.ctrv.2017.12.004","article-title":"Cancer immunotherapy in a neglected population: the current use and future of T-cell-mediated checkpoint inhibitors in organ transplant patients","volume":"63","author":"Chae","year":"2018","journal-title":"Cancer Treat Rev"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"121","DOI":"10.1681\/ASN.2020121753","article-title":"mTOR inhibitors prevent CMV infection through the restoration of functional \u03b1\u03b2 and \u03b3\u03b4 T cells in kidney transplantation","volume":"33","author":"Kaminski","year":"2022","journal-title":"J Am Soc Nephrol"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1914424\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T16:07:52Z","timestamp":1786637272000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1914424\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,13]]},"references-count":17,"alternative-id":["10.3389\/fmed.2026.1914424"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2026.1914424","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,13]]},"article-number":"1914424"}}