内容紹介
Summary
We experienced a case of curative resection as a multidisciplinary treatment for unresectable gastric cancer that attributed to peritoneal disseminations and direct invasion to other organs. Two courses of triplet chemotherapy(DCS therapy)were performed under enteral stent placement and nasoenteral nutrition for direct infiltration into the transverse colon with entire circumference stenosis. Distal gastrectomy and right hemicolectomy were performed as conversion therapy, and R0 resection was achieved. After the operation, S-1 as adjuvant chemotherapy was performed and there has been no relapse survival for 13 months since the operation. From this case, it seems that conversion therapy plays an important role in prognosis extension as a treatment strategy for Stage Ⅳ gastric cancer.
要旨
今回われわれは,腹膜播種および他臓器直接浸潤を来した切除不能胃癌に対して,集学的治療により治癒切除に至った症例を経験した。まず横行結腸への直接浸潤と全周性狭窄に対してステント留置と経管栄養管理の下,3剤併用化学療法(DCS療法)を2コース施行した。続いてconversion therapyとして幽門側胃切除術,結腸右半合併切除術を施行してR0切除に至った。術後補助療法としてS-1内服療法を1年間施行し,術後13か月無再発生存中である。本症例より,Stage Ⅳ胃癌の治療戦略としてconversion therapyが予後延長に重要な役割を果たすと考えられた。
目次
We experienced a case of curative resection as a multidisciplinary treatment for unresectable gastric cancer that attributed to peritoneal disseminations and direct invasion to other organs. Two courses of triplet chemotherapy(DCS therapy)were performed under enteral stent placement and nasoenteral nutrition for direct infiltration into the transverse colon with entire circumference stenosis. Distal gastrectomy and right hemicolectomy were performed as conversion therapy, and R0 resection was achieved. After the operation, S-1 as adjuvant chemotherapy was performed and there has been no relapse survival for 13 months since the operation. From this case, it seems that conversion therapy plays an important role in prognosis extension as a treatment strategy for Stage Ⅳ gastric cancer.
要旨
今回われわれは,腹膜播種および他臓器直接浸潤を来した切除不能胃癌に対して,集学的治療により治癒切除に至った症例を経験した。まず横行結腸への直接浸潤と全周性狭窄に対してステント留置と経管栄養管理の下,3剤併用化学療法(DCS療法)を2コース施行した。続いてconversion therapyとして幽門側胃切除術,結腸右半合併切除術を施行してR0切除に至った。術後補助療法としてS-1内服療法を1年間施行し,術後13か月無再発生存中である。本症例より,Stage Ⅳ胃癌の治療戦略としてconversion therapyが予後延長に重要な役割を果たすと考えられた。