title: Complete response to preoperative chemoradiotherapy in highly advanced gastric adenocarcinoma.
abstract: This report presents a case of highly advanced gastric cancer that achieved a histologically complete response (CR) to preoperative chemoradiotherapy with S-1 plus low-dose Cisplatin. A 60-year-old male patient underwent FDG positron emission tomography (PET) during a routine health examination. The patient was found to have swollen paraaortic lymph nodes. Shortly thereafter, he was diagnosed with gastric carcinoma with a type 2 tumor in the antrum with paraaortic lymph node metastases based on FDG-PET, endoscopic examination and abdominal computed tomography. After the completion of chemoradiation therapy (CRT), the tumor and the paraaortic lymph node metastases disappeared. The patient underwent surgery 5 wk after the completion of CRT, including a subtotal gastrectomy with Roux-en-Y reconstruction, D3 lymph node dissection and a left adrenalectomy. No cancer cells were detected in the resected specimen either in the primary lesion or lymph nodes, thus confirming a pathologically CR to CRT (CR grade 3). The patient has been stable and well without any evidence of recurrence for 48 mo after surgery. Such a preoperative CRT regimen might therefore be very effective for treatment of some advanced gastric cancers.
authors.affiliation: Hironori Shigeoka, Haruhiko Imamoto, Takushi Yasuda, Hitoshi Shiozaki, Department of Surgery, Kinki University School of Medicine, Osaka 589-8511, Japan.
authors.forename: Hironori
authors.initials: H
authors.lastname: Shigeoka
authors.forename: Haruhiko
authors.initials: H
authors.lastname: Imamoto
authors.forename: Yasumasa
authors.initials: Y
authors.lastname: Nishimura
authors.forename: Taro
authors.initials: T
authors.lastname: Shimono
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Furukawa
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Imamura
authors.forename: Takushi
authors.initials: T
authors.lastname: Yasuda
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Shiozaki