ID | 101822 |
Title Transcription | フクマク ハシュ オ トモナッタ コウド シンコウ イガン ニ タイスル TS 1 ニヨル ジュツゼン カガク リョウホウ ノ ユウヨウセイ
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Title Alternative | Utility of neoadjuvant chemotherapy with TS-1 for advanced gastric cancer accompanied by peritoneal dissemination
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Author |
Matsuyama, Kazuo
Yagi, Toshiyuki
Department of Surgery, Tokushima Prefectural Central Hospital
Ogata, Yorihiko
Department of Surgery, Tokushima Prefectural Central Hospital
Hirose, Toshiyuki
Department of Surgery, Tokushima Prefectural Central Hospital
Kanoh, Masashi
Department of Surgery, Tokushima Prefectural Central Hospital
Chikugo, Fumio
Department of Surgery, Tokushima Prefectural Central Hospital
Matsumura, Toshinobu
Department of Surgery, Tokushima Prefectural Central Hospital
Sumitomo, Masayuki
Department of Surgery, Tokushima Prefectural Central Hospital
Miki, Hitoshi
Department of Surgery, Tokushima Prefectural Central Hospital
Takai, Shigeharu
Department of Surgery, Tokushima Prefectural Central Hospital
Fujino, Ryozo
Department of Surgery, Tokushima Prefectural Central Hospital
Kurogami, Kazuyoshi
Department of Surgery, Tokushima Prefectural Central Hospital
Takahashi, Masamichi
Department of Histology, Tokushima Prefectural Central Hospital
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Keywords | advanced gastric cancer
peritoneal dissenimation
neoadjuvant chemotherapy
TS -1
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Content Type |
Journal Article
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Description | TS -1 is an oral anticancer agent developed by utilizing biochemical modulation. We
used TS -1in neoadjuvant chemotherapy for a patient with highly advanced gastric cancer that was accompanied by peritoneal dissemination. This enabled us to resect tumor. This patient was a60-year-old woman. Fluoroscopic upper gastrointestinal series revealed a circumferential, type4lesion extending from the middle of the corpus to the antrum. This was diagnosed by endoscopy as poorly differentiated adenocarcinoma. CT showed ascites, thickening of the gastric wall, and direct infiltration into the head of the pancreas. In endoscopy of the large bowel, a strawberry jelly-like elevation was detected at the ileum. This was diagnosed as poorly differentiated adenocarcinoma, and considered a metastatic lesion produced by dissemination. Chest CT showed a single metastasis in the upper lobe of the right lung. We gave her3cycles of combined TS-1and low-dose CDDP for neoadjuvant chemotherapy. On laparotomy, we found that there was no ascites, and miliary scars were present at several sites near the ascending colon. The antrum of the stomach firmly adhered to the head of the pancreas, and scarred. We judged that the tumor was resectable, and performed distal gastrectomy(D2)plus ileocecal resection(D2). In histopathological examination, poorly differentiated adenocarcinoma was detected only on a part of the muscular layer in the lesser curvature and posterior wall of the corpus, and marked fibrosis was observed in the submucosal layer. The effect of chemotherapy was histologically evaluated as grade2. The tumor was diagnosed as poorly differentiated adenocarcinoma(por), with muscularis propria(mp), lymph invasion2(ly2),vein invasion 0(v0)and degree of lymph node metastasis2(+)[n2(+)]. Tubular adenocarcinoma was detected in a part of the submucosal layer of the ileum. The patient was alive with cancer as of27months after operation. |
Journal Title |
四国医学雑誌
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ISSN | 00373699
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NCID | AN00102041
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Publisher | 徳島医学会
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Volume | 60
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Issue | 1-2
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Start Page | 39
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End Page | 44
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Sort Key | 39
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Published Date | 2004-05-25
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Remark | |
FullText File | |
language |
jpn
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