title: [A Case of Advanced Gastric Cancer Responding to Neoadjuvant Docetaxel/CDDP/S-1 Therapy with Metallic Stent Placement, Leading to Curative Surgery].
abstract: A 59-year-old man presented with epigastralgia. A diagnosis of advanced gastric cancer MLU, Circ, Type 3, 160 mm, tub2, cT4b (SI: panc), cN1, cM0, cH0, cP0, cCY0, cStage ⅢB was made. Because of difficulty with oral intake due to malignant outlet obstruction and tumor bleeding, endoscopic self-expanding metallic stent placement was performed. We administered chemotherapy involving docetaxel, cisplatin, and S-1(DCS). After 2 courses of chemotherapy, the primary lesion and regional lymph nodes had reduced in size. His response was judged as SD according to the RECIST criteria. The patient elected to undergo explorative laparotomy for assessment of the gastric cancer. The intraoperative findings showed that there was no pancreatic invasion, peritoneal dissemination, or distal metastasis, so a total gastrectomy and D2 lymph node dissection was performed. The pathological findings showed that there were very few cancer cells in the primary lesion, and a lymph node metastasis was found. The final stage was gastric cancer MLU, Circ, Type 3, 100 mm, muc, ypT4a(SE), ypN3a (13/51), ypM0, ypH0, ypP0, ypCY0, ypStage ⅢC. The therapy evaluation was Grade 1b. In summary, we encountered a patient with gastric cancer in whom curative surgery was made possible by undergoing chemotherapy and metallic stent placement.
authors.affiliation: Dept. of Surgery, Gastroenterological Center, Yokohama City University Medical Center.
authors.forename: Keiichi
authors.initials: K
authors.lastname: Yazawa
authors.forename: Chikara
authors.initials: C
authors.lastname: Kunisaki
authors.forename: Jun
authors.initials: J
authors.lastname: Kimura
authors.forename: Ryo
authors.initials: R
authors.lastname: Takagawa
authors.forename: Yuta
authors.initials: Y
authors.lastname: Minami
authors.forename: Hirochika
authors.initials: H
authors.lastname: Makino
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Suzuki
authors.forename: Akira
authors.initials: A
authors.lastname: Tsuburaya
authors.forename: Hirotoshi
authors.initials: H
authors.lastname: Akiyama
authors.forename: Itaru
authors.initials: I
authors.lastname: Endo
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002945:Cisplatin / Q000008:administration & dosage; D000077143:Docetaxel; D004338:Drug Combinations; D005743:Gastrectomy; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008670:Metals; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D010094:Oxonic Acid / Q000008:administration & dosage; D015607:Stents; D013274:Stomach Neoplasms / Q000473:pathology / Q000628:therapy*; D043823:Taxoids / Q000008:administration & dosage; D005641:Tegafur / Q000008:administration & dosage
chemical_list: D004338:Drug Combinations; D008670:Metals; D043823:Taxoids; C079198:S 1 (combination); D005641:Tegafur; D000077143:Docetaxel; D010094:Oxonic Acid; D002945:Cisplatin