title: [A Case of Stage IV Gastric Cancer Successfully Treated Using Salvage Surgery after S-1/CDDP Therapy].
abstract: A 75-year-old man admitted for left lateral abdominal pain was found to have advanced poorly differentiated gastric adenocarcinoma with abdominal para-aortic and Virchow's lymph node metastases, which was diagnosed to be clinical Stage IV (T3N3H0M1[LYM]). As curative surgery was not deemed possible, we started chemotherapy administration using S-1 (120mg/day)administered orally for 3 weeks and cisplatin(CDDP 100mg/body)administered intravenously on day 8. After 6 courses of chemotherapy, a CT scan showed that all lymph nodes metastases had disappeared, resulting in downstaging to clinical Stage II (T3[SE]N0H0P0M0). Thus, we performed total gastrectomy, lymph node dissection(D2), and splenectomy. Histological findings showed no residual tumor cells in any of the lymph nodes. However, cancer cells remained in the primary gastric lesion. The pathological response to chemotherapy was judged to be Grade 2. The patient has been recurrence-free for 5 years after surgery.
authors.affiliation: Dept. of Surgery, Saiseikai Yokohamashi Nanbu Hospital.
authors.forename: Yuko
authors.initials: Y
authors.lastname: Shimada
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Hayashi
authors.forename: Keisuke
authors.initials: K
authors.lastname: Minamizawa
authors.forename: Taisuke
authors.initials: T
authors.lastname: Shibuya
authors.forename: Daiji
authors.initials: D
authors.lastname: Nemoto
authors.forename: Hideto
authors.initials: H
authors.lastname: Yokoi
authors.forename: Tomoko
authors.initials: T
authors.lastname: Wada
authors.forename: Takuo
authors.initials: T
authors.lastname: Watanabe
authors.forename: Ryo
authors.initials: R
authors.lastname: Takagawa
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Murakami
authors.forename: Seiji
authors.initials: S
authors.lastname: Hasegawa
authors.forename: Tadao
authors.initials: T
authors.lastname: Fukushima
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Ike
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Rino
authors.forename: Munetaka
authors.initials: M
authors.lastname: Masuda
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy* / Q000601:surgery; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002945:Cisplatin / Q000008:administration & dosage; D004338:Drug Combinations; D006801:Humans; D008297:Male; D020360:Neoadjuvant Therapy; D010094:Oxonic Acid / Q000008:administration & dosage; D016879:Salvage Therapy; D013274:Stomach Neoplasms / 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