A Case of Advanced Gastric Cancer-Histological CR was Attained by One Course of Neoadjuvant Chemotherapy with S-1/CDDP

Masanori Tokunaga, Shigekazu Ohyama, Soya Nunobe, Naoki Hiki, Tetsu Fukunaga, Yasuyuki Seto and Toshiharu Yamaguchi

Department of Gastroenterological Surgery, Cancer Institute Hospital

A 69-year-old Japanese woman with gastric cancer was referred to our hospital for further management. Gastrointestinal fiberscopy revealed type 2 advanced gastric cancer in the posterior wall of the gastric cardia (cT4panc, cN2, cH0, cP0, cM0, cStage IV). In cases of advanced gastric cancer, neoadjuvant chemotherapy (NAC) with S-1/CDDP is usually admitted for tumor down-staging at our hospital. Since the patient agreed to undergo NAC, S-1 (80 mg/m²) was administered orally for 21 consecutive days, followed by intravenous CDDP (cisplatin, 60 mg/m²) on Day 8. Radiological examinations after NAC showed partial response of the primary and lymph node lesions. Subsequently total gastrectomy with extended lymph node dissection was performed. Histological examination of the resected specimen showed no cancer cells in either the stomach or any of the dissected lymph nodes. It was assumed that histological CR had been achieved by the NAC with S-1/CDDP. Although there are numerous reports of advanced gastric cancer cases, in which histological CR was achieved after two or more courses of NAC, histological CR was achieved after one course of NAC in the present case. Herein we report this very rare case in this paper with a review of the literature.

Key words
TS-1, neoadjuvant chemotherapy, complete response

Reprint requests
Masanori Tokunaga Department of Gastrointestinal Surgery, Cancer Institute Hospital
3-10-6 Ariake, Koto-ku Tokyo, 135-8550 JAPAN

Accepted
January 31, 2007

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