2019 Volume 80 Issue 4 Pages 707-713
A 70-year-old woman was referred to our department for her esophagogastric junction (EGJ) adenocarcinoma. Upper endoscopy revealed a type 2 circular tumor on the EGJ, and the initial diagnosis was GE, Siewert type II, cT3(SS), cN0, cM0 : cStage II. She received neoadjuvant chemotherapy with a combination of docetaxel, cisplatin, and 5-fluorouracil (biweekly-DCF). After 2 courses of chemotherapy, the tumor had remarkably reduced in size. The primary lesion had become only a small scar on the mucosal surface. There were no obvious lymph node swellings, ascites, or organ metastases. Preoperative diagnosis was GE type 0-IIc, Siewert type II, ycT1b, N0, M0 : yc Stage I. Laparoscopic transhiatal extended total gastrectomy was performed because of the tumor shrinkage. The operation time was 388 minutes and, blood loss was of 160 g. Pathological examination demonstrated no residual cancer cells in the primary lesion or lymph node (histopathological grade 3 ; pathological complete response [pCR]).
This study demonstrates that neoadjuvant biweekly-DCF chemotherapy can be a promising option for locally advanced EGJ adenocarcinoma Moreover, tumor shrinkage may lead to a complete resection under laparoscopic surgery.
Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association)
