title: [Marked response to S-1 chemotherapy for para-aortic lymph node metastasis arising from gastric cancer].
abstract: We report a recurrent case of gastric cancer with para-aortic lymph node metastasis that showed a marked response to systemic chemotherapy consisting of S-1 alone. A 70-year-old male was admitted to our hospital with appetite loss and left abdominal pain. He had a history of distal gastrectomy due to the advanced gastric cancer. Endoscopy revealed a submucosal tumor-like elevation with central ulcer, and the biopsy specimen was poorly-differentiated adenocarcinoma histologically. CT of the abdomen demonstrated a para-aortic lymph node swelling behind the remnant stomach, indicating an unresectable recurrent gastric cancer. We initially treated the patient with S-1 chemotherapy (60 mgx2/day) by oral administration. His tumor immediately responded to the chemotherapy, and restaging abdominal CT after 2 cycles of chemotherapy showed almost complete regression of lymph node metastasis. The patient has undergone S-1 chemotherapy and currently has remained in remission for more than 21 months with no severe adverse events. The S-1 regime was effective and safe, suggesting that S-1 could be the first-line chemotherapy for recurrent gastric cancer.
authors.affiliation: Chikuba Hospital for Gastrointestinal and Colorectal Surgery.
authors.forename: Fuminori
authors.initials: F
authors.lastname: Teraishi
authors.forename: Takeo
authors.initials: T
authors.lastname: Suzuki
authors.forename: Masako
authors.initials: M
authors.lastname: Nakamoto
authors.forename: Akira
authors.initials: A
authors.lastname: Chikuba
authors.forename: Masashi
authors.initials: M
authors.lastname: Nezu
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Shimamura
authors.forename: Takao
authors.initials: T
authors.lastname: Takiue
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Chikuba
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy* / Q000556:secondary / Q000601:surgery; D000368:Aged; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use*; D001011:Aorta; D004334:Drug Administration Schedule; D004338:Drug Combinations; D005743:Gastrectomy; D018530:Gastric Stump / Q000473:pathology*; D006801:Humans; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008297:Male; D010094:Oxonic Acid / 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; C079198:S 1 (combination); D005641:Tegafur; D010094:Oxonic Acid