Noro Hiroshi, Hirao Takafumi, Teranishi Ryugo, Shimura Yuhi, Todo Marie, Ohashi Tomofumi, Osawa Hideki, Sakai Kenji, Yasumasa Keigo, Iwasaki Teruo, Hatanaka Nobutaka, Yamasaki Yoshio
Dept. of Surgery, Japan Community Health care Organization(JCHO)Osaka Hospital.
Gan To Kagaku Ryoho. 2019 Apr;46(4):745-747.
A 66-year-old man underwent total gastrectomy for gastric cancer. S-1 was administered as adjuvant chemotherapy. Abdominal CT showed para-aortic lymph node recurrence 31 months after the surgery. There was no other recurrence according to PET-CT, and we performed para-aortic lymph nodes dissection 41 months after the surgery. Lymph node recurrence in the retrocrural space was observed 37 months after the 2nd surgery. We administered S-1 plus L-OHP chemotherapy. After 4 courses, CT revealed that he had achieved complete response, and he has remained disease-free for 79 months after lymph node dissection. Some patients with para-aortic lymph node recurrence after curative gastrectomy may benefit from treatment including chemotherapy and surgical dissection.
一名66岁男性因胃癌接受了全胃切除术。给予S-1作为辅助化疗。腹部CT显示术后31个月出现主动脉旁淋巴结复发。根据PET-CT检查，未发现其他复发情况，我们在术后41个月进行了主动脉旁淋巴结清扫术。第二次手术后37个月，观察到膈脚后间隙淋巴结复发。我们给予S-1联合奥沙利铂化疗。4个疗程后，CT显示患者达到完全缓解，淋巴结清扫术后已无病生存79个月。部分根治性胃切除术后发生主动脉旁淋巴结复发的患者可能从包括化疗和手术清扫在内的治疗中获益。
