title: [A case of advanced gastric cancer with para-aortic lymph node metastasis successfully treated with preoperative S-1/Lentinan chemotherapy followed by curative gastrectomy].
abstract: We report a case of advanced gastric cancer successfully treated with preoperative S-1/Lentinan (LTN)chemotherapy followed by curative gastrectomy. The patient was a 75-year-old man with right hypochondralgia. Endoscopic examination revealed a huge type 2 gastric cancer in the middle body of the stomach. Abdominal computed tomography (CT) revealed multiple perigastric lymph node metastases and bulky para-aortic lymph node metastases. The clinical diagnosis was cT 4N3M1( LYM) with cStage IV. We thought a complete resection would be difficult, so he was treated with S-1( 80 mg/m2 day 1-28/q6w) and LTN (2 mg weekly) in May 2010. After 3 courses, the primary lesion was markedly reduced, and gastric endoscopic biopsy showed no malignant lesion. After 4 courses, abdominal CT showed no lymph node swelling at the perigastric and para-aortic areas. After 5 courses, distal gastrectomy with D2 lymphadenectomy was performed. The histological diagnosis was ypT2( MP) N0M0, Stage IB. Histological features of the primary tumor and lymph nodes were judged to be Grade 2 and Grade 3, respectively. After surgery, S-1/LTN treatment was continued for 1 year. During this period, there were no serious adverse events. The patient has been in good health without recurrence for 28 months after surgery.
authors.affiliation: Dept. of Surgery, Osaka General Medical Center.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Nishikawa
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Iwase
authors.forename: Toyokazu
authors.initials: T
authors.lastname: Aono
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yoshida
authors.forename: Masaya
authors.initials: M
authors.lastname: Nomura
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Tamagawa
authors.forename: Chu
authors.initials: C
authors.lastname: Matsuda
authors.forename: Takashi
authors.initials: T
authors.lastname: Deguchi
authors.forename: Junji
authors.initials: J
authors.lastname: Kawada
authors.forename: Shigeyoshi
authors.initials: S
authors.lastname: Higashi
authors.forename: Koichi
authors.initials: K
authors.lastname: Deguchi
authors.forename: Yuki
authors.initials: Y
authors.lastname: Noguchi
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Okumura
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Nomura
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Fushimi
authors.forename: Mari
authors.initials: M
authors.lastname: Takagi
authors.forename: Akiko
authors.initials: A
authors.lastname: Fukui
authors.forename: Kazumasa
authors.initials: K
authors.lastname: Fujitani
authors.forename: Shunji
authors.initials: S
authors.lastname: Endo
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Tanaka
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001011:Aorta / Q000473:pathology*; D001706:Biopsy; D004338:Drug Combinations; D005743:Gastrectomy; D006801:Humans; D007912:Lentinan / Q000008:administration & dosage; D008207:Lymphatic Metastasis; D008297:Male; D020360:Neoadjuvant Therapy; D010094:Oxonic Acid / Q000008:administration & dosage; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D005641:Tegafur / Q000008:administration & dosage
chemical_list: D004338:Drug Combinations; C079198:S 1 (combination); D005641:Tegafur; D007912:Lentinan; D010094:Oxonic Acid