内容紹介
Summary
A 66-year-old man underwent chemotherapy with S-1 plus cisplatin plus trastuzumab to treat advanced gastric cancer that was diagnosed as cStage Ⅳ adenocarcinoma(T3N1M1[P0, CYX, H1]). After 8 courses, liver metastases were absent on contrast-enhanced MRI. The patient underwent a laparoscopic distal gastrectomy with D2 lymphadenectomy. The gross appearance of the surgically resected specimen showed a shrunk gastric tumor measuring 1 mm. The postoperative course was uneventful, and the patient has been well, receiving maintenance chemotherapy of S-1 plus trastuzumab without evidence of recurrence for 15 months following the operation. Conversion surgery following chemotherapy might be an effective treatment for patients with advanced gastric cancer; however, further studies are needed to establish this treatment strategy.
要旨
症例は66歳,男性。tub1(HER2発現3+),T3N1M1(P0,CYX,H1),cStage Ⅳの胃癌に対してS-1+cisplatin+trastuzumab(Tmab)療法を開始した。8コース終了後の造影MRI検査で肝転移は消失したため,腹腔鏡下幽門側胃切除術(D2郭清,BillrothⅡ再建術)を施行した。術中超音波検査でも肝転移は認めず,最終診断はypT1aN1M0,yfStageⅠB,化学療法効果判定はGrade 2であった。術後補助療法としてS-1+Tmab療法を施行し,術後15か月を経過した現在,無再発生存中である。
目次
A 66-year-old man underwent chemotherapy with S-1 plus cisplatin plus trastuzumab to treat advanced gastric cancer that was diagnosed as cStage Ⅳ adenocarcinoma(T3N1M1[P0, CYX, H1]). After 8 courses, liver metastases were absent on contrast-enhanced MRI. The patient underwent a laparoscopic distal gastrectomy with D2 lymphadenectomy. The gross appearance of the surgically resected specimen showed a shrunk gastric tumor measuring 1 mm. The postoperative course was uneventful, and the patient has been well, receiving maintenance chemotherapy of S-1 plus trastuzumab without evidence of recurrence for 15 months following the operation. Conversion surgery following chemotherapy might be an effective treatment for patients with advanced gastric cancer; however, further studies are needed to establish this treatment strategy.
要旨
症例は66歳,男性。tub1(HER2発現3+),T3N1M1(P0,CYX,H1),cStage Ⅳの胃癌に対してS-1+cisplatin+trastuzumab(Tmab)療法を開始した。8コース終了後の造影MRI検査で肝転移は消失したため,腹腔鏡下幽門側胃切除術(D2郭清,BillrothⅡ再建術)を施行した。術中超音波検査でも肝転移は認めず,最終診断はypT1aN1M0,yfStageⅠB,化学療法効果判定はGrade 2であった。術後補助療法としてS-1+Tmab療法を施行し,術後15か月を経過した現在,無再発生存中である。