内容紹介
Locally Advanced Gastric Cancer Treated with Curative Gastrectomy and Showing Pathological Complete Response after Chemotherapy with S-1
Summary
A 77-year-old man presented with epigastralgia. Gastrointestinal endoscopic examination showed advanced gastric cancer, type 3, in the distal antrum. The patient refused surgery and preferred chemotherapy. The regimen consisted of 80 mg/body/day of S-1, continuously administered from day 1-14, followed by discontinuation for 2 weeks. After 2 courses, the patient experienced fatigue and recurrent vomiting. Laboratory studies revealed severe anemia; the hemoglobin level was 5.5 g/dL. An upper gastrointestinal endoscopy revealed pyloric stenosis and significant tumor reduction. Therefore, distal gastrectomy was performed. Histological examination did not reveal any viable cancer cells in the stomach and lymph nodes. Thus, a Grade 3 postchemotherapeutic effect was revealed.
要旨
症例は77歳,男性。心窩部痛で近医から紹介。上部消化管内視鏡検査にて胃幽門前庭部後壁に進行胃癌を認めた。腹部CT検査では胃幽門前庭部周辺のリンパ節腫大を認めるも,遠隔転移は認めなかった。手術を勧めるが拒否され,抗癌剤治療を希望された。S-1による抗癌剤治療を開始した。2コース終了後に貧血による倦怠感と頻回の嘔吐を認めた。上部消化管内視鏡検査にて幽門狭窄所見と胃癌の縮小を確認した。幽門狭窄症のため幽門側胃切除術,D2郭清を施行した。切除病理組織標本では切除胃,リンパ節に遺残する癌細胞は認めなかった。
目次
Summary
A 77-year-old man presented with epigastralgia. Gastrointestinal endoscopic examination showed advanced gastric cancer, type 3, in the distal antrum. The patient refused surgery and preferred chemotherapy. The regimen consisted of 80 mg/body/day of S-1, continuously administered from day 1-14, followed by discontinuation for 2 weeks. After 2 courses, the patient experienced fatigue and recurrent vomiting. Laboratory studies revealed severe anemia; the hemoglobin level was 5.5 g/dL. An upper gastrointestinal endoscopy revealed pyloric stenosis and significant tumor reduction. Therefore, distal gastrectomy was performed. Histological examination did not reveal any viable cancer cells in the stomach and lymph nodes. Thus, a Grade 3 postchemotherapeutic effect was revealed.
要旨
症例は77歳,男性。心窩部痛で近医から紹介。上部消化管内視鏡検査にて胃幽門前庭部後壁に進行胃癌を認めた。腹部CT検査では胃幽門前庭部周辺のリンパ節腫大を認めるも,遠隔転移は認めなかった。手術を勧めるが拒否され,抗癌剤治療を希望された。S-1による抗癌剤治療を開始した。2コース終了後に貧血による倦怠感と頻回の嘔吐を認めた。上部消化管内視鏡検査にて幽門狭窄所見と胃癌の縮小を確認した。幽門狭窄症のため幽門側胃切除術,D2郭清を施行した。切除病理組織標本では切除胃,リンパ節に遺残する癌細胞は認めなかった。