A Case of Advanced Gastric Cancer in Which Complete Response was Confirmed with Resection Following Long-term TS-1/CDDP Combined Chemotherapy

Takaaki Sugiki, Tatsuo Inoue, Emiko Yanatori, Hirotaka Kamikozuru, Hidetoshi Oguma* and Ken Takasaki*

Department of Surgery, Kamifukuoka General Hospital
Department of Gastroenterological Surgery, Tokyo Women's Medical University*

The patient was a 59-year-old man with advanced gastric cancer and multiple lymph node metastases, including to a para-aortic lymph node. We concluded that curative resection would be difficult, and selected TS-1/CDDP combined chemotherapy instead. Each course consisted of TS-1 (100 mg/day) for 4 weeks and CDDP (60 mg/body) on days 7, 14, and 21. After the first course, the size of the primary lesion and enlarged lymph nodes decreased markedly, but the patient developed grade 3 thrombocytopenia. Later, as an outpatient, TS-1 (100 mg/day) was administered for 4 weeks with CDDP (10 mg/body) on days 1 and 15 for a total of 8 courses without toxicity. Upper GI endoscopy revealed the primary lesion to have formed a scar-like lesion, and a biopsy showed no cancer cells. CT revealed the maintenance of complete response (CR) for 13 months, but TS-1 administration was finally stopped because of grade 1 neuropathy. Five months after stopping chemotherapy, CR had been maintained, but because of the deformity of the stomach on an upper GI series the possibility of cancer cell survival could not be ruled out. We performed a distal gastrectomy, and the microscopic findings revealed marked fibrous change and no cancer cells in the gastric wall or lymph nodes, which were judged to be Grade 3. TS-1/CDDP combined chemotherapy is capable of curing advanced gastric cancer with severe lymph node metastasis without surgical resection.

Key words
gastric cancer, TS-1, CDDP

Reprint requests
Takaaki Sugiki Department of Surgery, Kamifukuoka General Hospital
931 Fukuoka, Fujimino, 356-0011 JAPAN

Accepted
June 22, 2005

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