内容紹介
Summary
A 75-year-old woman presented with difficulty in swallowing. Esophagogastroduodenoscopy(EGD)revealed a Borrmann type 3 advanced gastric cardia carcinoma. Computed tomography(CT)revealed three lymph node metastases, and thus, the preoperative diagnosis was cT4aN2M0, cStage ⅢB. However, the patient refused resection, and chemotherapy was initiated. The chemotherapy regimen was sequentially changed based on the macroscopic characteristics of the lesion: S-1 plus CDDP followed by S-1 alone, S-1 plus PTX, and PTX alone. We have continued to follow-up the lesion using EGD and CT, and have observed the macroscopic characteristics of the advanced gastric carcinoma treated without resection for 7 years.
要旨
症例は75歳,女性。上部消化管内視鏡で約12 cmの3型の噴門部胃癌を認めた。CTで3個のリンパ節転移が認められ,術前診断cT4aN2M0,cStage ⅢBと診断されたが,本人の意向で化学療法での治療が選択された。まずS-1+CDDPを行い,その後S-1単剤,S-1+PTX,PTX単剤と変更した。その経過中,上部消化管内視鏡およびCTにてフォローし,診断後7年を経過した現在もCRを維持し化学療法を行っている。7年間の内視鏡所見,3型進行胃癌の形態変化を中心に報告する。
目次
A 75-year-old woman presented with difficulty in swallowing. Esophagogastroduodenoscopy(EGD)revealed a Borrmann type 3 advanced gastric cardia carcinoma. Computed tomography(CT)revealed three lymph node metastases, and thus, the preoperative diagnosis was cT4aN2M0, cStage ⅢB. However, the patient refused resection, and chemotherapy was initiated. The chemotherapy regimen was sequentially changed based on the macroscopic characteristics of the lesion: S-1 plus CDDP followed by S-1 alone, S-1 plus PTX, and PTX alone. We have continued to follow-up the lesion using EGD and CT, and have observed the macroscopic characteristics of the advanced gastric carcinoma treated without resection for 7 years.
要旨
症例は75歳,女性。上部消化管内視鏡で約12 cmの3型の噴門部胃癌を認めた。CTで3個のリンパ節転移が認められ,術前診断cT4aN2M0,cStage ⅢBと診断されたが,本人の意向で化学療法での治療が選択された。まずS-1+CDDPを行い,その後S-1単剤,S-1+PTX,PTX単剤と変更した。その経過中,上部消化管内視鏡およびCTにてフォローし,診断後7年を経過した現在もCRを維持し化学療法を行っている。7年間の内視鏡所見,3型進行胃癌の形態変化を中心に報告する。