Journal of Okayama Medical Association
Published by Okayama Medical Association

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S-1/CDDP術前化学療法により組織学的CRが得られた幽門狭窄合併進行胃癌の1例

西崎 正彦 岡山大学大学院医歯薬学総合研究科 消化器外科学
藤原 康宏 広島市立広島市民病院 外科
丁田 泰宏 広島市立広島市民病院 外科
金澤 卓 広島市立広島市民病院 外科
二宮 基樹 広島市立広島市民病院 外科
藤原 俊義 岡山大学大学院医歯薬学総合研究科 消化器外科学
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抄録
A 59-year-old man with epigastric discomfort and anorexia was referred to our hospital. Endoscopy revealed a type 3 advanced gastric cancer with pyloric stenosis diagnosed as a poorly differentiated adenocarcinoma in the biopsy specimens. A gastrojejunal bypass operation was performed because of direct invasion to the pancreas. The patient was treated by three courses of neoadjuvant chemotherapy with S-1/CDDP. Follow-up abdominal CT scan revealed that the primary tumor had become smaller, suggesting that a partial response had been achieved. Distal gastrectomy with D2 lymphadenectomy was performed. The histopathological examination showed no residual cancer cells in the primary lesion or dissected lymph nodes. Final chemotherapy efficacy was evaluated as Grade 3. The patient was treated with S-1 for one year after the gastrectomy and lymphadenectomy and has been followed up for 18 months without evidence of recurrence.
キーワード
幽門狭窄 (pyloric stenosis)
進行胃癌 (advanced gastric cancer)
S-1/CDDP
術前化学療法 (neoadjuvant chemotherapy)
組織学的CR (pathological CR)
備考
症例報告(Case Report)
ISSN
0030-1558
NCID
AN00032489
DOI