title: Pathological complete response and long-term survival in a very elderly patient after neoadjuvant chemotherapy for locally advanced, unresectable gastric cancer.
abstract: We address the pathological complete response and long-term survival of elderly patients after neoadjuvant chemotherapy in locally advanced, unresectable gastric cancer. An 83-year-old man was hospitalized for upper abdominal pain. Gastrointestinal endoscopy showed a large tumor spanning from the gastric angle to the antrum, and extending to the duodenum. Histological analysis of the biopsy specimen revealed a poorly differentiated adenocarcinoma. Computed tomography images showed thickening of the gastric wall and invasion of the body and head of the pancreas, but did not show distant metastases. The patient was diagnosed with unresectable gastric cancer, and was treated with neoadjuvant chemotherapy using S-1 (80 mg/m(2)) and paclitaxel (60 mg/m(2)). After the third course of chemotherapy, gastrointestinal endoscopy and abdominal computed tomography revealed a remarkable reduction in tumor size. This reduction allowed distal gastrectomy to be conducted. Histological examination of the specimen revealed no cancer cells in the primary lesion or lymph nodes. The patient was treated with adjuvant chemotherapy of oral tegafur-uracil (300 mg/day) for one year after surgery. He lived for five years after surgery without recurrence. Neoadjuvant chemotherapy using S-1 and paclitaxel is a potent strategy for improving survival in very elderly patients with unresectable gastric cancer.
authors.affiliation: Department of Gastroenterological Surgery, Federation of Public Services and Affiliated Personnel Aid Associations, Takamatsu Hospital, 4-18 Tenjinmae, Takamatsu, Kagawa 760-0018, Japan.
authors.forename: Kunihiko
authors.identifier: 0000-0002-8390-1677
authors.initials: K
authors.lastname: Izuishi
authors.affiliation: Department of Internal Medicine of Gastroenterology, Federation of Public Services and Affiliated Personnel Aid Associations, Takamatsu Hospital, 4-18 Tenjinmae, Takamatsu, Kagawa 760-0018, Japan.
authors.forename: Mitsuyoshi
authors.initials: M
authors.lastname: Kobayashi
authors.affiliation: Department of Gastroenterological Surgery, Federation of Public Services and Affiliated Personnel Aid Associations, Takamatsu Hospital, 4-18 Tenjinmae, Takamatsu, Kagawa 760-0018, Japan.
authors.forename: Takanori
authors.identifier: 0000-0002-4828-5661
authors.initials: T
authors.lastname: Sano
authors.affiliation: Department of Gastroenterological Surgery, Federation of Public Services and Affiliated Personnel Aid Associations, Takamatsu Hospital, 4-18 Tenjinmae, Takamatsu, Kagawa 760-0018, Japan.
authors.forename: Hirohito
authors.initials: H
authors.lastname: Mori
authors.affiliation: Department of Gastroenterological Surgery, Federation of Public Services and Affiliated Personnel Aid Associations, Takamatsu Hospital, 4-18 Tenjinmae, Takamatsu, Kagawa 760-0018, Japan.
authors.forename: Kazuo
authors.initials: K
authors.lastname: Ebara