[A Case of Gastric Cancer with Extensive Lymph Node Metastasis Causing Stenosis Symptoms in the Primary pCR after Preoperative Chemotherapy].

Abstract

A 65‒year‒old man was found with a circumferential type 2 tumor in the gastric antrum by upper gastrointestinal endoscopy, and biopsy revealed poorly a differentiated adenocarcinoma and HER2‒negative results. According to imaging examinations and laparoscopy, he was diagnosed with an advanced gastric cancer, classified as cT4a(SE)N3M0 and cStage Ⅲ. He underwent neoadjuvant chemotherapy(SOX regimen)because of the bulky N finding. After 2 courses of the treatment, marked reductions in the primary gastric lesion and metastatic lymph nodes were observed, although stenosis appeared at the gastric tumor site. The W‒ED tube was used to depressurize the stomach and to manage his nutrition, and the patient's surgery was conducted under good general conditions. We performed a distal gastrectomy(D2 dissection)and cholecystectomy. Histopathological examination showed no viable tumor cells in the primary gastric lesion(Grade 3). Two metastases were found in the dissected lymph nodes, although only a few cancer cells persisted. We report a case of gastric cancer in which pCR was obtained in the primary lesion, although stenosis appeared after the neoadjuvant chemotherapy.

• Authors: Satoshi Mochizuki, Tomohiro Matsui, Naosuke Nakamichi, Hidekazu Hiramoto, Takeshi Ishimoto, Toshiyuki Kosuga, Masahiro Tsujiura, Susumu Nakashima, Mamoru Masuyama
• Journal: Gan to kagaku ryoho. Cancer & chemotherapy (Gan To Kagaku Ryoho) Vol. 48 Issue 4 Pg. 578-580 (Apr 2021) ISSN: 0385-0684 [Print] Japan
• PMID: 33976054 (Publication Type: Case Reports, Journal Article)

Chemical References

• Drug Combinations
• Tegafur
• Oxonic Acid

Topics

• Aged
• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Constriction, Pathologic
• Drug Combinations
• Gastrectomy
• Humans
• Lymphatic Metastasis
• Male
• Neoadjuvant Therapy
• Oxonic Acid (therapeutic use)
• Stomach Neoplasms (drug therapy, surgery)
• Tegafur (therapeutic use)