Furusawa Kohei, Higashida Masaharu, Kubota Hisako, Iwamoto Ryo, Kitagawa Shuji, Kinoshita Seiya, Ueno Michi, Mineta Shumei, Okamoto Yuko, Watanabe Yusaku, Okada Toshimasa, Tsuruta Atsushi, Fujiwara Yoshinori, Ueno Tomio
Dept. of Digestive Surgery, Kawasaki Medical School.
Gan To Kagaku Ryoho. 2019 Dec;46(13):2533-2535.
A 56-year-old woman diagnosed with type 2 gastric cancer and multiple lymph node metastases(T3N3M1[lym], cStage Ⅳ)was treated with chemotherapy using trastuzumab with S-1 plus cisplatin for 6 cycles. The primary lesion showed PR, and lymph node metastases disappeared after the chemotherapy. Because of adverse events, she was administered with 2 additional cycles of trastuzumab with S-1 plus cisplatin and 6 cycles of trastuzumab with capecitabine plus oxaliplatin. However, the primary lesion increased in size. Therefore, she underwent distal gastrectomy and D1+ lymphadenectomy with para-aortic lymph node sampling as a conversion surgery. The pathological diagnosis was T2N0M0, pStage ⅠB, and the primary cancer was Grade 1a owing to the chemotherapeutic effect. She survives without recurrence or postoperative adjuvant therapies 3 years after the surgery.
一名56岁女性被诊断为2型胃癌伴多发淋巴结转移（T3N3M1[lym]，c期Ⅳ），接受了曲妥珠单抗联合S-1加顺铂化疗6个周期。原发灶显示部分缓解，化疗后淋巴结转移消失。由于不良事件，她又接受了2个周期的曲妥珠单抗联合S-1加顺铂以及6个周期的曲妥珠单抗联合卡培他滨加奥沙利铂治疗。然而，原发灶大小增加。因此，她接受了远端胃切除术和D1+淋巴结清扫术，并进行了主动脉旁淋巴结取样作为挽救性手术。病理诊断为T2N0M0，p期ⅠB，由于化疗效果，原发性癌症为1a级。术后3年，她存活且无复发，也未接受术后辅助治疗。
