Abstract
A 51-year-old man admitted for anorexia and weight loss was found in an endoscopic examination to have type 1 cancer in the upper body of the stomach. Abdominal angiography and CT showed a portal vein thrombus and No.8 and 12 lymph nodes. Since curative surgery was not deemed possible, we started neoadjuvant chemotherapy using TS-1 plus cisplatin (CDDP) for down staging. TS-1 (100mg/body/day) was orally administered for 2 weeks followed by a drug-free 2-week period, and CDDP (100mg/body) was administered intravenously on day 8 as 1 course. The only side effect was mild myelosupression. After 4 courses of chemotherapy, lymph nodes were reduced in size, and the portal vein thrombus disappeared. Curative distalgastrectomy was then done. Histological change in neoadjuvant chemotherapy was judged to be Grade 1a for the main tumor. No lymph node metastasis was detected. There was no recurrence on CT and TS-1 was continued in the 1 year after surgery. Neoadjuvant chemotherapy using TS-1 plus CDDP is thus effective in advanced gastric cancer with portal vein thrombus.
