[A Case of Recurrent Gastric Cancer with Left Cervical Lymph Node and Para-Aortic Lymph Node Successfully Treated with TS-1 Chemotherapy].

Abstract

We report a case of recurrent gastric cancer with left cervical and para-aortic lymph node close to the hilum of the right kidney that was successfully treated with TS-1 monotherapy and surgical resection. The patient was a 55-year-old woman. She underwent total gastrectomy with D2 lymphadenectomy for gastric cancer in June 2002. Histopathological examination revealed type 4, por1, pT3 (SE), pN1 (#4d: 1/5), H0, P0, M0, CY0, pStageⅢA. She refused to receive adjuvant chemotherapy. At 1 year 7 months after gastrectomy, she noticed cervical lymph node swelling. Computed tomography (CT) revealed a 2.5 cm diameter lymph node. Histopathological examination of an aspiration needle biopsy specimen from the left cervical lymph node confirmed that the tumors had metastasized from gastric cancer. Treatment with TS-1 (120 mg/day) was initiated in January 2004 and continued for 2 years 5 months. A complete response was achieved 5 months after treatment initiation and continued until the present. Abdominal CT revealed a para-aortic lymph node that tended to increase in size. Positron emission tomography revealed accumulation with a standardized uptake value in the lymph node. Because it was a solitary tumor, we performed tumor resection in October 2009, histopathologically confirming the lymph node metastasis. Subsequently, the patient was again treated with TS-1 monotherapy again until the present. She is currently alive 5 years 9 months after the surgery, without any signs of disease recurrence.

• Authors: Kazuhiro Nishikawa, Junji Kawada, Kazumasa Fujitani, Hiroaki Fushimi, Shunji Endo, Motohiro Hirao, Kazuyoshi Yamamoto, Sakae Maeda, Naotsugu Haraguchi, Masakazu Miyake, Naoki Hama, Atsushi Miyamoto, Masataka Ikeda, Shoji Nakamori, Mitsugu Sekimoto
• Journal: Gan to kagaku ryoho. Cancer & chemotherapy (Gan To Kagaku Ryoho) Vol. 42 Issue 12 Pg. 2075-7 (Nov 2015) ISSN: 0385-0684 [Print] Japan
• PMID: 26805269 (Publication Type: Case Reports, English Abstract, Journal Article)

Chemical References

• Silicates
• titanium silicide
• Titanium

Topics

• Aorta (pathology)
• Female
• Gastrectomy
• Humans
• Lymph Node Excision
• Lymph Nodes (pathology)
• Lymphatic Metastasis
• Middle Aged
• Neck (pathology)
• Recurrence
• Silicates (therapeutic use)
• Stomach Neoplasms (drug therapy, pathology, surgery)
• Titanium (therapeutic use)