Abstract
A 68-year-old man was referred to our hospital with a diagnosis of gastric cancer. Gastrointestinal endoscopic examination showed a type3 tumor which had indiscrete border at the posterior wall of the gastric upper body. Abdominal CT scan showed swelling of multiple lymph nodes on the lesser curvature side and para-aortic lymph node swelling which appeared to be lymph nodes metastases, as well as a tumor about 2cm in size which appeared to be liver metastases in the S3 of liver. Therefore, we diagnosed the case as gastric cancer T2N3H1M0, StageIV. He was initially treated with 2 courses of TS-1+cisplatin. After the second course, abdominal CT scan showed remarkable shrinkage of lymph node swelling on the lesser curvature side, and disappearance of para-aortic lymph node swelling. We thus performed total gastrectomy+lymph node dissection (D3)+S3 partial hepatectomy. Histological findings showed no residual tumor cells in the primary gastric lesion and lymph nodes. The primary gastric lesion and lymph nodes were evaluated Grade3 as the effect of the preoperative chemotherapy. The patient has been recurrence-free as of 12 months after the operation.
It seems that neoadjuvant chemotherapy can provide improvement of the prognosis even for advanced gastric cancer.
