A Case of Splenic-Hilum Lymph Node Recurrence after Spleen Preserving Total Gastrectomy for Gastric Cancer Following Neoadjuvant Chemotherapy

A 69-year-old man was diagnosed with a large type 3, cT4bN2M0, cStage III c advanced gastric cancer located at the lesser curvature of the upper stomach. Neoadjuvant chemotherapy with S-1 plus CDDP was administered, and partial response was obtained after 2 courses. Subsequently, spleen preserving t...

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Bibliographic Details
Published inGan to kagaku ryoho Vol. 43; no. 12; p. 2222
Main Authors Nishino, Masaya, Okano, Miho, Hoshino, Hiromitsu, Kawada, Junji, Okuyama, Masaki, Kim, Yongkook, Tsujinaka, Toshimasa
Format Journal Article
LanguageJapanese
Published Japan 01.11.2016
Subjects
Aged
Antineoplastic Combined Chemotherapy Protocols - therapeutic use
Combined Modality Therapy
Gastrectomy
Hepatectomy
Humans
Liver Neoplasms - drug therapy
Liver Neoplasms - secondary
Liver Neoplasms - surgery
Lymphatic Metastasis
Male
Neoadjuvant Therapy
Recurrence
Spleen - pathology
Stomach Neoplasms - drug therapy
Stomach Neoplasms - pathology
Stomach Neoplasms - surgery
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Summary:A 69-year-old man was diagnosed with a large type 3, cT4bN2M0, cStage III c advanced gastric cancer located at the lesser curvature of the upper stomach. Neoadjuvant chemotherapy with S-1 plus CDDP was administered, and partial response was obtained after 2 courses. Subsequently, spleen preserving total gastrectomy with partial hepatectomy was performed. The final pathological diagnosis was UM, Less, yType 3, por1, ypT4b(SI liver), was ly2, v1, ypN2, M0, pStage III c, R0. Adjuvant chemotherapy with S-1 was administered; however, 5 months after the surgery, splenic-hilum lymph node recurrence was detected. Chemotherapy with CPT-11 plus CDDP was administered and a salvage operation was planned when the response to treatment was nonCR or nonPD. After 6 courses of chemotherapy, the treatment response was PR. Nine months after the first operation, spleno-pancreatic tail resection combined with partial hepatectomy was performed. The patient is currently disease-free without chemotherapy.
ISSN:0385-0684