内容紹介
A Case of Resected Gastric Cancer Invading the Esophagus with Esophageal Recurrence That Responded to Weekly Docetaxel/Cisplatin Chemotherapy
Summary
A 77-year-old man underwent total gastrectomy with D1+ lymph node dissection after being diagnosed with cT4aN2M0, cStage ⅢB gastric cancer. Peritoneal dissemination was detected in the bursa omentalis. The pathological diagnosis after surgery was pT4aN3b(21/41)M1(P1). He was treated with 6 courses of S-1 chemotherapy. Two years after surgery, upper gastrointestinal endoscopy revealed the presence of a tumor in the mid-thoracic esophagus. It was diagnosed to as metastatic esophageal cancer and treated with combination chemotherapy consisting of docetaxel(25 mg/m2, days 1, 8, 15)and cisplatin(25 mg/m2, days 1, 8, 15)in a 28-day cycle. A clinically complete response was observed after 5 courses of chemotherapy. Currently, the patient is alive with no signs of recurrence 12 months after the initial recurrence.
要旨
症例は77歳,男性。2012年3月に胃癌,UME,cT4aN2M0,cStage ⅢBの診断で胃全摘D1+郭清術を施行した。術中網嚢内に腹膜播種結節を認め,病理組織学的にUME,Less,pType 3,por1>tub2,pT4aN3b(21/41)M1(P1),fStage Ⅳと診断した。術後化学療法(S-1: 80 mg/m2)を6コース実施後,有害事象により化学療法を中止し,経過観察となっていた。術後2年の上部消化管内視鏡検査で,胸部中部食道に隆起性病変を認め,病理組織学的には管腔構造を有した腺癌細胞増殖として認め,胃癌の食道転移と診断し,少量weekly docetaxel(25 mg/m2)/cisplatin(25 mg/m2)療法(3週投与1週休薬)を開始した。5コース実施後の上部消化管内視鏡検査で隆起性病変は消失し,全身検索においても再発所見を認めなかった。現在,無再発経過観察中である。
目次
Summary
A 77-year-old man underwent total gastrectomy with D1+ lymph node dissection after being diagnosed with cT4aN2M0, cStage ⅢB gastric cancer. Peritoneal dissemination was detected in the bursa omentalis. The pathological diagnosis after surgery was pT4aN3b(21/41)M1(P1). He was treated with 6 courses of S-1 chemotherapy. Two years after surgery, upper gastrointestinal endoscopy revealed the presence of a tumor in the mid-thoracic esophagus. It was diagnosed to as metastatic esophageal cancer and treated with combination chemotherapy consisting of docetaxel(25 mg/m2, days 1, 8, 15)and cisplatin(25 mg/m2, days 1, 8, 15)in a 28-day cycle. A clinically complete response was observed after 5 courses of chemotherapy. Currently, the patient is alive with no signs of recurrence 12 months after the initial recurrence.
要旨
症例は77歳,男性。2012年3月に胃癌,UME,cT4aN2M0,cStage ⅢBの診断で胃全摘D1+郭清術を施行した。術中網嚢内に腹膜播種結節を認め,病理組織学的にUME,Less,pType 3,por1>tub2,pT4aN3b(21/41)M1(P1),fStage Ⅳと診断した。術後化学療法(S-1: 80 mg/m2)を6コース実施後,有害事象により化学療法を中止し,経過観察となっていた。術後2年の上部消化管内視鏡検査で,胸部中部食道に隆起性病変を認め,病理組織学的には管腔構造を有した腺癌細胞増殖として認め,胃癌の食道転移と診断し,少量weekly docetaxel(25 mg/m2)/cisplatin(25 mg/m2)療法(3週投与1週休薬)を開始した。5コース実施後の上部消化管内視鏡検査で隆起性病変は消失し,全身検索においても再発所見を認めなかった。現在,無再発経過観察中である。