title: [A Case of Advanced Gastric Cancer with Para-Aortic Lymph Node Dissection after Neoadjuvant Chemotherapy].
abstract: The patient was a 49-year-old woman with advanced gastric cancer.CT and PET-CT revealed para-aortic lymph node metastases.She was diagnosed with Stage IV T4aN3M1(LYM)and underwent neoadjuvant chemotherapy with S-1 plus CDDP.After 3 courses, both the tumor and para-aortic lymph node metastases decreased in size.Because radical resection was considered possible, she underwent distal gastrectomy with D3(D2+No.1 6a2-b1)dissection and Roux-en-Y reconstruction. Histopathological findings revealed the cancer was Stage I B(yp T1b N1)with the disappearance of cancer cells in the para-aortic lymph nodes.She was discharged on POD 32.She underwent adjuvant chemotherapy with S-1 and was followed up for 3 years with no recurrence.Para -aortic lymph node metastases are factors predicting a poor outcome; however, when neoadjuvant chemotherapy is effective, long-term survival can be expected from gastrectomy with curative PAND.
authors.affiliation: Dept. of Surgery, Hiroshima City Hiroshima Citizens Hospital.
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Ogawa
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Choda
authors.forename: Motoki
authors.initials: M
authors.lastname: Ninomiya
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Nagai
authors.forename: Naoki
authors.initials: N
authors.lastname: Mimura
authors.forename: Soichiro
authors.initials: S
authors.lastname: Miyake
authors.forename: Michihiro
authors.initials: M
authors.lastname: Ishida
authors.forename: Hiroyoshi
authors.initials: H
authors.lastname: Matsukawa
authors.forename: Yasutomo
authors.initials: Y
authors.lastname: Ojima
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Idani
authors.forename: Shigehiro
authors.initials: S
authors.lastname: Shiozaki
authors.forename: Masazumi
authors.initials: M
authors.lastname: Okajima
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001011:Aorta / Q000473:pathology / Q000601:surgery; D002945:Cisplatin / Q000008:administration & dosage; D004338:Drug Combinations; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology / Q000601:surgery; D008207:Lymphatic Metastasis; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D010094:Oxonic Acid / Q000008:administration & dosage; D013274:Stomach Neoplasms / Q000098:blood supply / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D005641:Tegafur / Q000008:administration & dosage
chemical_list: D004338:Drug Combinations; C079198:S 1 (combination); D005641:Tegafur; D010094:Oxonic Acid; D002945:Cisplatin