2024 Volume 49 Issue 2 Pages 53-59
A 60-year-old man was diagnosed with esophagogastric junction cancer by upper GI endoscopy for hematemesis. The cancer was clinically classified as EG cType3 cT3N1M0 cStage Ⅲ (Japanese classification of gastric carcinoma, the 15th edition). Preoperative chemotherapy was administered because the patient could not be hospitalized for 2 months for personal reasons.
A combination of S-1 and oxaliplatin (SOX) therapy was administered on an outpatient basis. Proximal gastrectomy with D2 lymph node dissection was performed after two courses of SOX.
Postoperative pathological examination detected no cancer cells in the esophagogastric junction and resected lymph nodes. The pathological response was Grade 3.
This favorable outcome after neoadjuvant chemotherapy was relatively rare. Previous major clinical studies on advanced gastric cancer reported pathological complete response rates of 2%–24%. Although SOX therapy is available on an outpatient basis and may be useful as one of the regimens for neoadjuvant chemotherapy, currently no consensus on neoadjuvant chemotherapy has been established in Japan. The results of future clinical trials are awaited.
