title: [A case of Barrett's esophageal carcinoma treated with combined therapy].
abstract: During a routine health examination, a 50-year-old man was found to have an elevated lesion at the esophagogastric junction. Poorly differentiated adenocarcinoma was diagnosed from the biopsy findings. Computed tomography showed metastases in the mediastinal, intra-abdominal, and paraaortic lymph nodes. The clinical stage diagnosis was cT2, cN4, cM0, cStage IVa. Combination chemotherapy with docetaxel, CDDP, and 5-FU (DCF) was started initially. After 2 courses of DCF, the primary lesion and mediastinal lymph nodes had decreased in size, but the intra-abdominal lymph node had grown. A curative operation with paraaortic lymph node dissection was considered possible; thus, video-assisted thoracoscopic surgery of the esophagus with 3-field lymph node dissection was performed. The final findings revealed Barrett's esophageal carcinoma, EG, 0-III,23×18 mm, mod-por, CT-pT1b (sm3) pN4, sM0, fStage IV. Histologically, the mediastinal lymph node metastases disappeared with chemotherapy, but no reduction was observed in the abdominal lymph nodes. After surgery, 2 courses of combination adjuvant chemotherapy with CDDP and 5-FU were administered along with 50 Gy of radiotherapy. Subsequently, the treatment was changed to tegafur-gimeracil-oteracil potassium alone on an outpatient basis. The patient remains recurrence free 22 months postsurgery.
authors.affiliation: Dept. of Surgery, Maebashi Red Cross Hospital, Japan.
authors.forename: Yujin
authors.initials: Y
authors.lastname: Suto
authors.forename: Naoki
authors.initials: N
authors.lastname: Tomizawa
authors.forename: Tatsumasa
authors.initials: T
authors.lastname: Andoh
authors.forename: Kazuhisa
authors.initials: K
authors.lastname: Arakawa
authors.forename: Katsumi
authors.initials: K
authors.lastname: Kobayashi
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Sato
authors.forename: Kazuha
authors.initials: K
authors.lastname: Sakamoto
authors.forename: Hideaki
authors.initials: H
authors.lastname: Itoh
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Sunose
authors.forename: Izumi
authors.initials: I
authors.lastname: Takeyoshi
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001471:Barrett Esophagus / Q000473:pathology / Q000628:therapy*; D059248:Chemoradiotherapy; D002945:Cisplatin / Q000008:administration & dosage; D000077143:Docetaxel; D004938:Esophageal Neoplasms / Q000473:pathology / Q000628:therapy*; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D043823:Taxoids / Q000008:administration & dosage
chemical_list: D000970:Antineoplastic Agents; D043823:Taxoids; D000077143:Docetaxel; D002945:Cisplatin; D005472:Fluorouracil