A Case of Advanced Gastric Cancer Responding to TS-1/CDDP Therapy was Pathological Complete Response

Osamu Shiraishi, Shigeru Hatabe*, Shinpei Ishikawa*, Yoshinori Kitano*, Masayasu Kawasaki*, Keniti Sakai*, Akira Hayashibe*, Sadao Hunai* and Masao Kameyama*

Department of Surgery, Kinki University School of Medicine
Department of Surgery, Bellland General Hospital*

A 59-year old man admitted for anorexia was found to have advanced poorly differentiated gastric adenocarcinoma with abdominal paraaortic lymph node metastasis, clinical stage IV (T4 (SI) N3H0P0M0). Since curative surgery was deemed not possible, we started chemotherapy using TS-1 (120 mg/day) orally administered for three weeks and cisplatin (CDDP) (100 mg/body) administered intravenously on day 8. After grade 3 pancytopenia developed, we reduced TS-1 to 100 mg/day and CDDP to 70 mg/body. After two courses of chemotherapy, the primary lesion shrank and paraaortic lymph node metastases were no larger noted in abdominal computed tomography, achieving down-staging to clinical stage IIIA (T3 (SE) N1H0P0M0). After upper abdominal evisceration and dissection of a paraaortic lymph node (D3), cancer cells disappeared in both the main tumor and lymph nodes, and histological efficacy was evaluated as grade 3. He has had no recurrence as of 27 months postoperatively.

Key words
neoadjuvant chemotherapy, gastric cancer

Reprint requests
Osamu Shiraishi Department of Surgery, Kinki University School of Medicine
377-2 Ohno-Higashi, Osaka-Sayama, Osaka, 589-8511 JAPAN

Accepted
April 25, 2007

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