A Case of Advanced Gastric Cancer with Portal Vein Thrombus Responding to TS-1 Plus CDDP Neoadjuvant Chemotherapy

Masaya Uesato, Yasushi Shinohara, Naotake Akutu, Masashi Suzuki, Masayuki Kano, Satoshi Chiba, Haruo Satou, Akio Sakamoto and Takenori Ochiai*

Department of Surgery, Narutou Genaral Hospital
Department of Academic Surgery, Chiba University Graduate School of Medicine*

A 51-year-old man admitted for anorexia and weight loss was found in an endoscopic examination to have type 1 cancer in the upper body of the stomach. Abdominal angiography and CT showed a portal vein thrombus and No. 8 and 12 lymph nodes. Since curative surgery was not deemed possible, we started neoadjuvant chemotherapy using TS-1 plus cisplatin (CDDP) for down staging. TS-1 (100 mg/body/day) was orally administered for 2 weeks followed by a drug-free 2-week period, and CDDP (100 mg/body) was administered intravenously on day 8 as 1 course. The only side effect was mild myelosupression. After 4 courses of chemotherapy, lymph nodes were reduced in size, and the portal vein thrombus disappeared. Curative distalgastrectomy was then done. Histological change in neoadjuvant chemotherapy was judged to be Grade 1a for the main tumor. No lymph node metastasis was detected. There was no recurrence on CT and TS-1 was continued in the 1 year after surgery. Neoadjuvant chemotherapy using TS-1 plus CDDP is thus effective in advanced gastric cancer with portal vein thrombus.

Key words
TS-1, gastric cancer, portal vein thrombus

Reprint requests
Masaya Uesato Department of Surgery, Narutou Genaral Hospital
167 Narutou, Sanbu, 289-1326 JAPAN

Accepted
February 22, 2006

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