title: [A Case of Advanced Gastric Cancer with Extensive Lymph Node Metastases Treated by Capecitabine plus Cisplatin plus Trastuzumab Chemotherapy,Followed by Conversion Surgery].
abstract: An 82-year-old woman underwent upper gastrointestinal endoscopy to evaluate upper abdominal pain.A type 2 tumor (adenocarcinoma, por, HER2+)was found in the lesser curvature of the gastric antrum.Abdominal CT showed bulky lymph node metastases and pancreatic invasion of lymph node No.6 , resulting in a diagnosis of cT3N3M0, Stage III B.Radical resection was not possible by gastrectomy, and chemotherapy(capecitabine plus cisplatin plus trastuzumab)was administered. The primary lesion and lymph node showed significant regression on CT after the administration of 8 courses of chemotherapy, which also clarified the border between the lymph node and pancreas.At this stage, it was determined that radical resection was feasible; distal gastrectomy(Roux-en-Y reconstruction)and D2 dissection and cholecystectomy were performed.No cancer cells were found in the primary lesion on histopathology.The therapeutic effect of preoperative chemotherapy was assessed as Grade 3, pCR, and retained tumor was only found in lymph node No.5 . On follow-up observation, the patient is alive 11 months after surgery, with no evidence of recurrence without neoadjuvant chemotherapy.
authors.affiliation: Dept. of Gastroenterological Surgery, Sendai Kousei Hospital.
authors.forename: Sho
authors.initials: S
authors.lastname: Yasuta
authors.forename: Junichiro
authors.initials: J
authors.lastname: Yamauchi
authors.forename: Kento
authors.initials: K
authors.lastname: Miyazaki
authors.forename: Mamoru
authors.initials: M
authors.lastname: Sato
authors.forename: Tomoya
authors.initials: T
authors.lastname: Ikeda
authors.forename: Shota
authors.initials: S
authors.lastname: Fujita
authors.forename: Keiichi
authors.initials: K
authors.lastname: Shirasaki
authors.forename: Shin
authors.initials: S
authors.lastname: Kobayashi
authors.forename: Takashi
authors.initials: T
authors.lastname: Ajiki
authors.forename: Katsuo
authors.initials: K
authors.lastname: Tsuchihara
authors.forename: Noriko
authors.initials: N
authors.lastname: Kondo
authors.forename: Shuichi
authors.initials: S
authors.lastname: Ishiyama
mesh_terms: D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D000069287:Capecitabine / Q000008:administration & dosage; D002945:Cisplatin / Q000008:administration & dosage; D005260:Female; D005743:Gastrectomy; D006801:Humans; D008207:Lymphatic Metastasis; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D000068878:Trastuzumab / Q000008:administration & dosage; D016896:Treatment Outcome
chemical_list: D000069287:Capecitabine; D000068878:Trastuzumab; D002945:Cisplatin