内容紹介
Summary
The efficacy of postoperative chemotherapy for patients with ypStageⅠ gastric cancer has not been evaluated. We investigated the characteristics and prognosis of 7 patients with ypStageⅠ gastric cancer. cStages were ⅡA, ⅡB, ⅢB, and Ⅳ in 1, 1, 1, and 4 patients, respectively. S-1 plus cisplatin and docetaxel plus cisplatin plus S-1 were administered in 5 and 2 patients, respectively, for 2-8 courses before gastrectomy. Microscopic curative resection was performed for all patients. ypStage was 0, ⅠA, and ⅠB in 1, 2, and 4 patients. All patients received postoperative chemotherapy with S-1 or docetaxel plus S-1(DS). The 5-year recurrence-free survival was 71% and the 5-year overall survival was 68%. Two patients developed recurrence. One patient developed recurrence 1 year and 1 month after gastrectomy in spite of S-1 treatment for 4 months. Another patient developed recurrence 11 months after gastrectomy after DS treatment for 4 months followed by S-1. The other 5 patients received S-1 for 1-5 years and have survived without recurrence. Although the prognosis of ypStageⅠ gastric cancer was comparatively good, the regimen and courses of postoperative chemotherapy should be evaluated in a prospective study.
要旨
化学療法後に胃切除を施行しypStageⅠとなった胃癌症例の特徴,術後補助化学療法および予後について検討した。ypStageⅠ症例は7例存在し,治療前のcStageはⅡA :ⅡB :ⅢB :Ⅳ=1 :1 :1 :4例であった。化学療法レジメンはS-1+cisplatin :docetaxel+cisplatin+S-1=5 :2例で2～8コース施行されていた。術式は胃全摘 :幽門側胃切除=3 :4例で,全例R0切除が施行された。ypStageは0 :IA :IB=1 :2 :4例で,術後は全例でS-1もしくはdocetaxel+S-1(DS)による術後補助化学療法を施行された。5年無再発生存率71%,5年全生存率は68%であった。7例中2例で再発を認め,うち1例は術後4か月間S-1を服用し,術後1年1か月目に再発を認めた。もう1例はDS療法を4か月間施行し,その後S-1内服中の術後11か月目に再発を認めた。残りの5例は術後1～5年間S-1を内服し,無再発生存中である。ypStageⅠ症例の予後は化学療法を施行しなかった進行胃癌と同等であり,術後補助化学療法が必要と考えられた。その内容や期間については検討の余地があると考える。
目次
The efficacy of postoperative chemotherapy for patients with ypStageⅠ gastric cancer has not been evaluated. We investigated the characteristics and prognosis of 7 patients with ypStageⅠ gastric cancer. cStages were ⅡA, ⅡB, ⅢB, and Ⅳ in 1, 1, 1, and 4 patients, respectively. S-1 plus cisplatin and docetaxel plus cisplatin plus S-1 were administered in 5 and 2 patients, respectively, for 2-8 courses before gastrectomy. Microscopic curative resection was performed for all patients. ypStage was 0, ⅠA, and ⅠB in 1, 2, and 4 patients. All patients received postoperative chemotherapy with S-1 or docetaxel plus S-1(DS). The 5-year recurrence-free survival was 71% and the 5-year overall survival was 68%. Two patients developed recurrence. One patient developed recurrence 1 year and 1 month after gastrectomy in spite of S-1 treatment for 4 months. Another patient developed recurrence 11 months after gastrectomy after DS treatment for 4 months followed by S-1. The other 5 patients received S-1 for 1-5 years and have survived without recurrence. Although the prognosis of ypStageⅠ gastric cancer was comparatively good, the regimen and courses of postoperative chemotherapy should be evaluated in a prospective study.
要旨
化学療法後に胃切除を施行しypStageⅠとなった胃癌症例の特徴,術後補助化学療法および予後について検討した。ypStageⅠ症例は7例存在し,治療前のcStageはⅡA :ⅡB :ⅢB :Ⅳ=1 :1 :1 :4例であった。化学療法レジメンはS-1+cisplatin :docetaxel+cisplatin+S-1=5 :2例で2～8コース施行されていた。術式は胃全摘 :幽門側胃切除=3 :4例で,全例R0切除が施行された。ypStageは0 :IA :IB=1 :2 :4例で,術後は全例でS-1もしくはdocetaxel+S-1(DS)による術後補助化学療法を施行された。5年無再発生存率71%,5年全生存率は68%であった。7例中2例で再発を認め,うち1例は術後4か月間S-1を服用し,術後1年1か月目に再発を認めた。もう1例はDS療法を4か月間施行し,その後S-1内服中の術後11か月目に再発を認めた。残りの5例は術後1～5年間S-1を内服し,無再発生存中である。ypStageⅠ症例の予後は化学療法を施行しなかった進行胃癌と同等であり,術後補助化学療法が必要と考えられた。その内容や期間については検討の余地があると考える。