Abstract
A 71-year-old woman developed anorexia and general fatigue and was admitted. Endoscopy showed a type 3 advanced gastric cancer lesion from the gastric body to the antrum. She was diagnosed as T4a, N2, M0, stage IIIB. During the operation, the tumor was found to have invaded the pancreas and duodenum ; peritoneal dissemination was observed up to the hepatoduodenal ligament. A gastrojejunostomy was performed for pyloric stenosis. After the operation the patient received combined chemotherapy with TS-1 + paclitaxel. Endoscopic biopsy performed after 4 cycles of chemotherapy showed no cancer cells ; metastatic lymph nodes were not visible on computed tomography. The chemotherapy was discontinued because the patient experienced grade 3 general fatigue and appetite loss. Subsequently, distal gastrectomy and D2 lymphadenectomy were performed. The pathological specimens showed no cancer cells in the primary gastric lesion or lymph nodes. Four years after surgery, the patient is still alive without relapse. This case suggests that TS-1 + paclitaxel chemotherapy is effective because for this patient with advanced gastric cancer has had a complete remission.
