内容紹介
A Case of Gastric Cancer in Which Grade 2 Treatment Effects Were Obtained with Preoperative Two-Week S-1 Administration
Summary
In our hospital, a clinical trial on the effects of preoperative 2-week S-1 administration for advanced gastric cancer is being conducted. A 75-year-old man presented to our hospital with a type 2 tumor(poorly differentiated adenocarcinoma)in the pyloric antrum. Subpyloric lymph node enlargement and a c-T2(MP), N1, M0, StageⅡA tumor(according to the gastric cancer handling agreement, 14th edition)were diagnosed, and S-1(100 mg/day)was subsequently administered for 14 days. On day 15, we performed laparoscopy-assisted distal gastrectomy, with D2 dissection. Analysis of the resected specimen, ie the primary tumor and metastatic lymph nodes, confirmed the effect of the treatment as Grade 2, and revealed a type 2 gastric cancer of 30×20 mm in size; this tumor was downstaged to yp-T1b(SM), N1, StageⅠB. No adverse events associated with perioperative S-1 were observed, and the postoperative course was good. At the latest follow-up(6 years after treatment), no recurrence was observed.
要旨
当院では,進行胃癌に対して術前2週間のS-1投与を行い,組織学的な効果と各種蛋白発現の相関を検証する臨床試験を実施している。症例は75歳,男性。胃幽門前庭部に2型を呈する低分化型腺癌を認めた。腹部CTにて幽門下リンパ節腫大あり,c-T2(MP),N1,M0,Stage ⅡA(胃癌取扱い規約第14版)と診断し,S-1(100 mg/日)を14日間投与した。15日目に腹腔鏡下幽門側胃切除術,D2郭清を施行した。切除標本では30×20 mmの2型胃癌を認め,原発巣と転移リンパ節ともにGrade 2の治療効果が確認でき,yp-T1b(SM),N1,Stage ⅠBでdown stageが得られた。周術期S-1による有害事象は認めず術後経過は良好で,6年以上経過した現在も再発を認めていない。
目次
Summary
In our hospital, a clinical trial on the effects of preoperative 2-week S-1 administration for advanced gastric cancer is being conducted. A 75-year-old man presented to our hospital with a type 2 tumor(poorly differentiated adenocarcinoma)in the pyloric antrum. Subpyloric lymph node enlargement and a c-T2(MP), N1, M0, StageⅡA tumor(according to the gastric cancer handling agreement, 14th edition)were diagnosed, and S-1(100 mg/day)was subsequently administered for 14 days. On day 15, we performed laparoscopy-assisted distal gastrectomy, with D2 dissection. Analysis of the resected specimen, ie the primary tumor and metastatic lymph nodes, confirmed the effect of the treatment as Grade 2, and revealed a type 2 gastric cancer of 30×20 mm in size; this tumor was downstaged to yp-T1b(SM), N1, StageⅠB. No adverse events associated with perioperative S-1 were observed, and the postoperative course was good. At the latest follow-up(6 years after treatment), no recurrence was observed.
要旨
当院では,進行胃癌に対して術前2週間のS-1投与を行い,組織学的な効果と各種蛋白発現の相関を検証する臨床試験を実施している。症例は75歳,男性。胃幽門前庭部に2型を呈する低分化型腺癌を認めた。腹部CTにて幽門下リンパ節腫大あり,c-T2(MP),N1,M0,Stage ⅡA(胃癌取扱い規約第14版)と診断し,S-1(100 mg/日)を14日間投与した。15日目に腹腔鏡下幽門側胃切除術,D2郭清を施行した。切除標本では30×20 mmの2型胃癌を認め,原発巣と転移リンパ節ともにGrade 2の治療効果が確認でき,yp-T1b(SM),N1,Stage ⅠBでdown stageが得られた。周術期S-1による有害事象は認めず術後経過は良好で,6年以上経過した現在も再発を認めていない。