Abstract
A 59-year old man admitted for anorexia was found to have advanced poorly differentiated gastric adenocarcinomawith abdominal paraaortic lymph node metastasis, clinical stage IV (T4 (SI) N3H0P0M0). Since curative surgery was deemed not possible, we started chemotherapy using TS-1 (120mg/day) orally administered for three weeks and cisplatin (CDDP)(100mg/body) administered intravenously on day 8. After grade 3 pancytopeniadeveloped, we reduced TS-1 to 100mg/day and CDDP to 70mg/body. After two courses of chemotherapy, the primary lesion shrank and paraaortic lymph node metastases were no larger noted in abdominal computedtomography, achieving down-staging to clinical stage IIIA (T3 (SE) N1H0P0M0). After upper abdominalevisceration and dissection of a paraaortic lymph node (D3), cancer cells disappeared in both the main tumorand lymph nodes, and histological efficacy was evaluated as grade 3. He has had no recurrence as of 27 months postoperatively.
