title: [Curative Surgery for Advanced Gastric Cancer with Extensive Lymph Node Metastasis after Long-Term Chemotherapy].
abstract: A 65-year-old man was diagnosed with HER2-positive gastric cancer considered unresectable owing to multiple distant lymph node metastases. After long-term chemotherapy, the original lesion disappeared, while peri-gastric lymph node metastases remained. Therefore, we performed lower mediastinal lymph node dissection, total gastrectomy with regional lymph node dissection (D2) and cholecystectomy. Pathological evaluation indicated that the main gastric tumor showed complete response, while there was metastasis in the No.3 lymph nodes, which showed HER2 positivity (3+). At present, the patient has received Xeloda plus trastuzumab and remains relapse-free 5 months after conversion surgery.
authors.affiliation: Dept. of Organ Regulatory Surgery, Fukushima Medical University.
authors.forename: Shotaro
authors.initials: S
authors.lastname: Fujita
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Monma
authors.forename: Shinji
authors.initials: S
authors.lastname: Ohki
authors.forename: Yuko
authors.initials: Y
authors.lastname: Murakami
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Okayama
authors.forename: Takashi
authors.initials: T
authors.lastname: Yazawa
authors.forename: Masashi
authors.initials: M
authors.lastname: Takawa
authors.forename: Kensuke
authors.initials: K
authors.lastname: Kumamoto
authors.forename: Toru
authors.initials: T
authors.lastname: Ohtake
authors.forename: Koji
authors.initials: K
authors.lastname: Kono
authors.forename: Seiichi
authors.initials: S
authors.lastname: Takenoshita
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D005743:Gastrectomy; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D013997:Time Factors; D016896:Treatment Outcome