Gan to kagaku ryoho. Cancer & chemotherapy

[A case of advanced gastric cancer with bulky lymph node metastases responding to S-1/CDDP neoadjuvant chemotherapy and leading to less invasive surgery and a pathologically complete response].

PMID 23863661


A 53-year-old man was diagnosed with advanced gastric cancer(cT4aN2M0, StageIII B), with regional bulky lymph node metastases invading the splenic artery. S-1 plus cisplatin treatment(S-1/CDDP)was administered as neoadjuvant chemo- therapy(NAC). S-1(80mg/m2)was administered orally for 21 days, followed by 14 drug-free days as a course. CDDP(60 mg/m2)was administered by intravenous drip on day 8. After two courses, significant tumor reduction was obtained, and the patient then had total gastrectomy and splenectomy performed with a D2 dissection. Distal pancreatectomy was avoided. Macroscopically, the stomach seemed to be penetrated by the tumor into the serosa, yet the histological diagnosis revealed complete disappearance of cancer cells in all of the lymph nodes, and very few residual tumor cells were noted, only on the gastric mucosa(pT1aN0M0, Stage I A). Therefore, downstaging was confirmed. S-1/CDDP as a NAC regimen for advanced gastric cancer appears to be an effective treatment.