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
Title Alternative
Utility of neoadjuvant chemotherapy with TS-1 for advanced gastric cancer accompanied by peritoneal dissemination
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
Keywords
advanced gastric cancer
peritoneal dissenimation
neoadjuvant chemotherapy
TS -1
Content Type
Journal Article
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
ISSN
00373699
NCID
AN00102041
Publisher
徳島医学会
Volume
60
Issue
1-2
Start Page
39
End Page
44
Sort Key
39
Published Date
2004-05-25
Remark
FullText File
language
jpn