[Long-term survival case of advanced gastric cancer with paraaortic lymph node metastasis and peritoneal metastasis from S-1/CDDP combination therapy after reductive operation].
A 72-year-old female patient with type 5 gastric cancer in the upper gastric region underwent surgery. Due to paraaortic lymph node metastasis (#16a1, #16a2) and peritoneal metastasis, total gastrectomy and D0 lymph node dissection were performed. Surgical and pathological findings were poorly differentiated adenocarcinoma, INFbeta, pT3(SE), PM (-), DM (-), ly0, v2, sN3 (#7, #9, #16a1-a2), M0, stage IV. The patient was administered S-1 for 2 weeks at 80 mg/day, received 24-hour continuous intravenous infusion of 80 mg/day on day 8, and then discontinued chemotherapy for 2 weeks, which was regarded as one course. After one course, CT scan showed that the paraaortic lymph node metastasis had almost entirely disappeared. However, due to grade 3 neutropenia, and grade 2 nausea and anorexia in the first course, the treatment was changed to oral administration of UFT (400 mg/day) , which was discontinued one month later due to anorexia. The patient has been in good health without a recurrence for 4 years after surgery. This case suggests that reduction surgery combined with a S-1 regimen is an effective treatment for long-term survival.
Akagi
Junji
J
Dept. of Surgery, National Hospital Organization Kumamoto Minami Hospital.
Masuda
Yoshihiro
Y
Takai
Eiji
E
Takemoto
Takahiro
T
Fukami
Kensaku
K
Yagishita
Yoshihiro
Y
D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001011:Aorta / Q000187:drug effects / Q000473:pathology; D002945:Cisplatin / Q000627:therapeutic use*; D004338:Drug Combinations; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis / Q000188:drug therapy / Q000473:pathology; D009367:Neoplasm Staging; D010094:Oxonic Acid / Q000627:therapeutic use*; D013274:Stomach Neoplasms / Q000098:blood supply / Q000188:drug therapy* / Q000473:pathology* / Q000601:surgery; D005641:Tegafur / Q000627:therapeutic use*; D013997:Time Factors; D014057:Tomography, X-Ray Computed
D004338:Drug Combinations; C079198:S 1 (combination); D005641:Tegafur; D010094:Oxonic Acid; D002945:Cisplatin