A Case of Advanced Gastric Cancer with Para-Aortic Lymph Node Dissection after Neoadjuvant Chemotherapy
Ogawa, T.; Choda, Y.; Ninomiya, M.; Nagai, Y.; Mimura, N.; Miyake, S.; Ishida, M.; Matsukawa, H.; Ojima, Y.; Idani, H.; Shiozaki, S.; Okajima, M.
Gan to Kagaku Ryoho. Cancer and ChemoTherapy 43(12): 2205-2207
2016
ISSN/ISBN: 0385-0684 PMID: 28133270 Document Number: 686920
The patient was a 49-year-old woman with advanced gastric cancer.CT and PET-CT revealed para-aortic lymph node metastases.She was diagnosed with Stage IV T4aN3M1(LYM)and underwent neoadjuvant chemotherapy with S-1 plus CDDP.After 3 courses, both the tumor and para-aortic lymph node metastases decreased in size.Because radical resection was considered possible, she underwent distal gastrectomy with D3(D2+No.1 6a2-b1)dissection and Roux-en-Y reconstruction. Histopathological findings revealed the cancer was Stage I B(yp T1b N1)with the disappearance of cancer cells in the para-aortic lymph nodes.She was discharged on POD 32.She underwent adjuvant chemotherapy with S-1 and was followed up for 3 years with no recurrence.Para -aortic lymph node metastases are factors predicting a poor outcome; however, when neoadjuvant chemotherapy is effective, long-term survival can be expected from gastrectomy with curative PAND.