Mori Yoshihiro, Ohtani Hiroshi, Tamamori Yutaka, Inoue Takeshi, Azuma Takashi
Dept. of Surgery, Osaka City Sumiyoshi Hospital.
Gan To Kagaku Ryoho. 2012 Apr;39(4):657-61.
CASE 1: A 72-year-old man with epigastralgia was diagnosed with gastric cancer and referred to our hospital. An abdominal CT scan revealed liver metastasis and para-aortic lymph node metastasis. He was treated with S-1+CDDP. After 4 courses of this treatment, the liver metastasis and para-aortic lymph node metastasis disappeared, and adjuvant surgery was performed. There has been no recurrence for 16 months postoperatively. CASE 2: A 66-year-old man with anorexia was diagnosed with gastric cancer and referred to our hospital. An abdominal CT scan revealed para-aortic lymph node metastasis. He was treated with S-1+CDDP. After 9 courses of this treatment, para-aortic lymph node metastasis disappeared, and adjuvant surgery was performed. Eight months after the operation, lymph node metastases were confirmed by abdominal CT scan, and he was treated with chemotherapy as an outpatient as of 13 months after the operation. We experienced two cases of Stage IV gastric cancer undergoing adjuvant surgery after down staging by chemotherapy. It was suggested that adjuvant surgery to highly advanced gastric cancer could improve the prognosis of patients.
病例1：一名72岁上腹部疼痛的男性被诊断为胃癌并转诊至我院。腹部CT扫描显示有肝转移和主动脉旁淋巴结转移。他接受了S-1+顺铂治疗。经过4个疗程的这种治疗后，肝转移和主动脉旁淋巴结转移消失，随后进行了辅助手术。术后16个月无复发。病例2：一名66岁厌食的男性被诊断为胃癌并转诊至我院。腹部CT扫描显示有主动脉旁淋巴结转移。他接受了S-1+顺铂治疗。经过9个疗程的这种治疗后，主动脉旁淋巴结转移消失，随后进行了辅助手术。术后8个月，腹部CT扫描证实有淋巴结转移，术后13个月起他作为门诊患者接受化疗。我们经历了2例IV期胃癌患者在化疗降期后接受辅助手术的病例。提示对高度进展期胃癌进行辅助手术可改善患者预后。
