[A case of advanced gastric cancer with para-aortic lymph node metastases responding to S-1/CDDP chemotherapy that leads to a pathological complete response].

A 66-year-old man complaining of epigastralgia was referred to our hospital. We examined the patient and diagnosed advanced gastric cancer (ML, type 3, por, cT3, cN3, cH0, cP0, cM1[LYM], cStage IV). A poor outcome was predicted, so we attempted induction chemotherapy and expected tumor downstaging. We chose S-1/CDDP therapy. S-1 was administered orally for 21 days, followed by CDDP div on day 8. Total gastrectomy and lymph node dissection (D2+No. 12a, No. 13,16) was performed using Roux-en-Y reconstruction. Histological examination of the resected stomach and lymph nodes revealed no residual cancer cells, suggesting complete histological remission (grade 3) according to the Japanese classification of gastric carcinoma. The patient has been in good health without recurrence for 12 months after surgery.