内容紹介
Summary
A 57-year-old man was diagnosed with advanced gastric cancer(adenocarcinoma[tub2/por1])with multiple(S3, S4, S5, S6, S8)liver and para-aortic lymph node metastases. The tumor was classified as cT4a, N3, M1, HEP, cStage Ⅳ, and the patient received chemotherapy with S-1 plus CDDP(SP). After 10 courses of SP, a CT scan revealed that the primary tumor and the metastases disappeared. The patient presented with cCR and underwent distal gastrectomy, D2 lymph node dissection, partial hepatic resection, and cholecystectomy. The histological diagnosis was classified as ypT0N0M0,(ypStage 0), pCR, and pathological Grade 3.
要旨
症例は57歳,男性。胃角から前庭小弯に2型進行胃癌を認めた。腹部CTで多発肝転移,固有肝動脈近傍のリンパ節に転移を認め,cT4a,N3,M1,HEP,cStage Ⅳと診断し,S-1+CDDP(SP)療法を開始した。SP 10コース施行後,内視鏡所見はS1 stage潰瘍,病理所見はGroup 1となり,PET-CTでは原発巣・転移巣に異常集積を認めなかった。conversion therapyの方針となり,幽門側胃切除術+胆囊摘出術+肝部分切除術を施行した。病理組織診断では原発巣および転移巣に腫瘍組織遺残を認めず,化学療法効果はGrade 3であった。
目次
A 57-year-old man was diagnosed with advanced gastric cancer(adenocarcinoma[tub2/por1])with multiple(S3, S4, S5, S6, S8)liver and para-aortic lymph node metastases. The tumor was classified as cT4a, N3, M1, HEP, cStage Ⅳ, and the patient received chemotherapy with S-1 plus CDDP(SP). After 10 courses of SP, a CT scan revealed that the primary tumor and the metastases disappeared. The patient presented with cCR and underwent distal gastrectomy, D2 lymph node dissection, partial hepatic resection, and cholecystectomy. The histological diagnosis was classified as ypT0N0M0,(ypStage 0), pCR, and pathological Grade 3.
要旨
症例は57歳,男性。胃角から前庭小弯に2型進行胃癌を認めた。腹部CTで多発肝転移,固有肝動脈近傍のリンパ節に転移を認め,cT4a,N3,M1,HEP,cStage Ⅳと診断し,S-1+CDDP(SP)療法を開始した。SP 10コース施行後,内視鏡所見はS1 stage潰瘍,病理所見はGroup 1となり,PET-CTでは原発巣・転移巣に異常集積を認めなかった。conversion therapyの方針となり,幽門側胃切除術+胆囊摘出術+肝部分切除術を施行した。病理組織診断では原発巣および転移巣に腫瘍組織遺残を認めず,化学療法効果はGrade 3であった。