Abstract
The patient was a 43-year-old man with gastric cancer (diameter, 10 cm) involving the celiac artery. The tumor had spread to the peri-aortic region and extensive lymph node metastasis was observed. Because the cancer was diagnosed as cT3N3M1 (LYM) Stage IV (Gastric Cancer Management Protocol, 14th Edition), curative resection was considered impossible. We started S-1 + cis-diamminedichloroplatinum (II) (CDDP) chemotherapy as a palliative treatment. Significant reduction was observed in tumor size at the end of the second course. Because curative resection of the tumor was considered possible at the end of the sixth course of chemotherapy, we performed a total gastrectomy along with D2 + No.16a2-b1 lymph node dissection. Histopathological findings revealed that it was Stage IA (ypT1b, ly0, v0, N0). Although extensive para-aortic lymph node metastasis is a poor prognostic factor, curative resection was made possible by S-1 + CDDP chemotherapy in this patient. Therefore, prognostic improvement may be observed in some patients with unresectable gastric cancer who are treated by this combination therapy.
