Abstract
We report a case of gastric cancer with para-aortic lymphnode metastasis responding to preoperative chemotherapy (Paclitaxel (PTX) /Cisplatin (CDDP) /S-1) completely on pathology and surviving 5 years without recurrence. The patient was a 68-year-old man with advanced gastric cancer. Computed tomography (CT) scan showed para-aortic lymphnode metastasis. We thought a complete resection would be difficult, so he was given neoadjuvant chemotherapy combined with PTX, CDDP and S-1. After four courses of this neoadjuvant chemotherapy, both the tumor and the lymph node metastasis decreased in size. Radical resection was considered possible. He underwent distal gastrectomy with left adorenectomy and D2 + para-aortic lymph node dissection with curative intent. The pathological diagnosis revealed the complete disappearance of cancer cells in both the primary lesion of the stomach and lymph nodes, confirming a pathological complete response. The postoperative course was uneventful. The patient has been followed up for 5 years, including 2 years administration of S-1 with no evidence of recurrence. Advanced gastric cancer with para-aortic lymph node metastasis without other non-curative factors, can achieve long-term survival can be expected by combining a curative operation with PTX/CDDP / S-1 combined therapy.
