title: [A case of advanced gastric cancer with bulky N2 lymph node metastases resected after successful treatment with TS-1].
abstract: We report a case of advanced gastric cancer with bulky N2 lymph node metastases resected after successful treatment with novel oral anticancer drug TS-1 as a neoadjuvant chemotherapy (NAC). A 62-year-old man was admitted to our hospital complaining of epigastralgia and dysphagia. Endoscopic examination revealed type 3 advanced gastric cancer in the upper gastric body. Computed tomography (CT) showed bulky N2 lymph node metastases. He was treated with a daily dose of 120 mg of TS-1 for 4 consecutive weeks, followed by 2 weeks of rest. No serious adverse reaction was observed. After 1 course of treatment, the primary tumor and metastatic lymph nodes were reduced. Therefore, a total gastrectomy combined with splenectomy and D2 lymph node dissection was performed. Histopathologically, a few viable cancer cells remained in the resected stomach and metastatic lymph nodes were found. The histological effect of NAC was judged to be grade 2. The patient's postoperative course was uneventful, and he has been well for 11 months following surgery. TS-1 as NAC is considered to be effective for advanced gastric cancer.
authors.affiliation: First Dept. of Surgery, Sapporo University School of Medicine, Muroran City General Hospital.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Takashima
authors.forename: Kiyoteru
authors.initials: K
authors.lastname: Kashiwagi
authors.forename: Kenichi
authors.initials: K
authors.lastname: Sasaki
authors.forename: Daisei
authors.initials: D
authors.lastname: Inoue
authors.forename: Hiroki
authors.initials: H
authors.lastname: Maeda
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Shibuya
authors.forename: Koichi
authors.initials: K
authors.lastname: Hirata
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy* / Q000556:secondary / Q000601:surgery; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D004334:Drug Administration Schedule; D004338:Drug Combinations; D005743:Gastrectomy; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D010094:Oxonic Acid / Q000627:therapeutic use*; D011300:Preoperative Care; D011725:Pyridines / Q000627:therapeutic use*; D012074:Remission Induction; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D005641:Tegafur / Q000627:therapeutic use*
chemical_list: D000964:Antimetabolites, Antineoplastic; D004338:Drug Combinations; D011725:Pyridines; C079198:S 1 (combination); D005641:Tegafur; D010094:Oxonic Acid