An oral anticancer drug, TS-1, enabled a patient with advanced gastric cancer with Virchow's metastasis to receive curative resection

被引：16

作者：

Iwazawa T. ^{[1
]}

Kinuta M. ^{[1
]}

Yano H. ^{[1
]}

Matsui S. ^{[1
]}

Tamagaki S. ^{[1
]}

Yasue A. ^{[1
]}

Okada K. ^{[1
]}

Kanoh T. ^{[1
]}

Tono T. ^{[1
]}

Nakano Y. ^{[1
]}

Okamoto S. ^{[2
]}

Monden T. ^{[1
]}

机构：

[1] Department of Surgery, NTT West Osaka Hospital, Tennouji-ku, Osaka 543-8922

[2] Department of Pathology, NTT West Osaka Hospital, Osaka

来源：

Gastric Cancer | 2002年 / 5卷 / 2期

关键词：

Gastrectomy; Gastric cancer; Neoadjuvant chemotherapy; TS-1; Virchow's lymph node metastasis;

D O I：

10.1007/s101200200016

中图分类号：

学科分类号：

摘要：

We encountered a patient with advanced gastric cancer, with Virchow's lymph node metastasis, who subsequently underwent curative resection after neoadjuvant chemotherapy with the newly developed oral anticancer drug, TS-1. The patient was a 67-year-old woman who had a type 2 tumor in the middle third of the stomach, and Virchow's lymph node metastasis, which was diagnosed by fine-needle aspiration cytology; she also had swollen paraaortic lymph nodes. Curative resection was considered impossible, and TS-1 (100mg/day) was administered for 28 days in one course, mainly in the outpatient clinic. Although grade 2 stomatitis interrupted the therapy on day 21 of the second course and on day 7 of the third course, the type 2 tumor showed marked remission (partial response; PR) and the metastasis in the Virchow's and paraaortic lymph nodes had completely disappeared after the third course (complete response; CR). Eleven weeks after the completion of the TS-1 treatment, total gastric resection with D3 lymph node dissection was performed. Histopathological examination revealed tumor involvement only in the mucosal and submucosal layers of the stomach and the no. 4d lymph node. Most of the tumor was replaced with fibrosis with granulomatous change in the muscularis propria of the stomach and in the no. 3, no. 6, and no. 7 lymph nodes. This may be the first report of a patient with advanced gastric cancer with Virchow's lymph node metastasis who successfully received curative resection following neoadjuvant chemotherapy with a single oral anticancer drug.

引用

页码：96 / 101

页数：5

共 22 条

[1]

Japanese classification of gastric carcinoma, Gastric Cancer, 1, pp. 10-24, (1998)

[2]

Preusser P., Wilke H., Achterrath W., Fink U., Lenaz L., Heinicke A., Et al., Phase II study with the combination etoposide, doxorubicin, and cisplatin in advanced measurable gastric cancer, J Clin Oncol, 7, pp. 1310-1317, (1989)

[3]

Boku N., Ohtsu A., Shimada Y., Shirao K., Seki S., Saito H., Et al., Phase II study of a combination of irinotecan and cisplatin against metastatic gastric cancer, J Clin Oncol, 17, pp. 319-323, (1999)

[4]

Nakajima T., Ota K., Ishihara S., Oyama S., Nishi M., Ohashi Y., Et al., Combined intensive chemotherapy and radical surgery for incurable gastric cancer, Ann Surg Oncol, 4, pp. 203-208, (1997)

[5]

Yonemura Y., Sawa T., Kinoshita K., Matsuki N., Fushida S., Tanaka S., Et al., Neoadjuvant chemotherapy for high-grade advanced gastric cancer, World J Surg, 17, pp. 256-262, (1993)

[6]

Murad A.M., Santiago F.F., Petroianu A., Rocha P.R.S., Rodrigues M.A.G., Rausch M., Modified therapy with 5-fluorouracil, doxorubicin, and methotrexate in advanced gastric cancer, Cancer, 72, pp. 37-41, (1993)

[7]

Glimelius B., Hoffman K., Haglund U., Nyren O., Sjoden P.O., Initial or delayed chemotherapy with best supportive care in advanced gastric cancer, Ann Oncol, 5, pp. 189-190, (1994)

[8]

Pyrhonen S., Kuitunen T., Nyandoto P., Kouri M., Randomized comparison of fluorouracil, epidoxorubicin and methotrexate (FEMTX) plus supportive care with supportive care alone in patients with non-resectable gastric cancer, Br J Cancer, 71, pp. 587-591, (1995)

[9]

Wils J.A., Klein H.O., Wagener D.J.T., Bleiberg H., Reis H., Korsten F., Et al., Sequential high-dose methotrexate and fluorouracil combined with doxorubicin - A step ahead in the treatment of advanced gastric cancer: A trial of the European Organization for Research and Treatment of Cancer Gastrointestinal Tract Cooperative Group, J Clin Oncol, 9, pp. 827-831, (1991)

[10]

Kelsen D., Atiq O.T., Saltz L., Niedzwiecki D., Ginn D., Chapman D., Et al., FAMTX versus etoposide, doxorubicin, and cisplatin: A random assignment trial in gastric cancer, J Clin Oncol, 10, pp. 541-548, (1992)

← 1 2 3 →