Vol.64 No.4 July 2016
Advanced gastric cancer for which pathological complete response (pCR) was achieved through neoadjuvant chemotherapy: a case report
1)Department of Surgery, Hachinohe Red Cross Hospital, 2 Nakaakedo, Tamonoki, Hachinohe, Aomori, Japan
2)Department of Digestive Organs, Hachinohe Red Cross Hospital
Abstract
Introduction
Neoadjuvant chemotherapy(NAC) has been performed in various institutions for the treatment of advanced gastric cancer, and has achieved favorable results in a clinical study. We therefore report our experience regarding a case of advanced gastric cancer with para-aortic lymph node metastasis in which pCR was achieved with NAC.
Case
Abnormalities were detected with fluoroscopy examination in a 71-year-old woman during gastric cancer screening. She subsequently visited a local hospital for a secondary complete examination. Upper gastrointestinal endoscopy showed a protruding lesion at the gastric antrum, and the patient was referred to our hospital for the purpose of complete examination and medical treatment. The patient was diagnosed as having advanced gastric cancer (cStage IV). The patient was scheduled to undergo two courses of S-1+CDDP. The chemotherapy achieved reduction in the size of both the primary tumor and lymph node No. 16, and based on this finding surgery consisting of total gastrectomy+D2+No. 16 lymph node dissection+splenectomy was performed. Postoperatively, the histological effect was determined to be Grade 3, and the patient was diagnosed as having achieved pCR. The patient started adjuvant chemotherapy. At 18 months postoperatively, the patient was alive and relapse-free.
Discussion
Although pCR was attained in some reports from Japan, to the best of our knowledge, only five Japanese cases achieved pCR through NAC for the treatment of advanced gastric cancer with advanced para-aortic lymph node metastasis, similar to the present case. In the future, it will be essential to select patients who would benefit from undergoing chemotherapy in conjunction with waiting for results from any clinical study, the aim of which was to validate the effects of NAC.
Key word
gastric cancer, neoadjuvant chemotherapy (NAC), pathological complete response (pCR)
Received
October 28, 2015
Accepted
February 29, 2016
Jpn. J. Chemother. 64 (4): 663-667, 2016
