A 77-year-old male had complaints of epigastralgia. Gastrointestinal endoscopic examination revealed type 2advanced gastric cancer. Computed tomography revealed metastatic Bulkey group 2lymph nodes. The diagnosis was sStage IIIB gastric cancer (sT3 sN2sH0 sP0 CY0) at staging laparoscopy. S-1 (100 mg/body/day) was orally administered for 3 weeks followed by a drug-free 2weeks, and CDDP (74 mg/body/day) was given intravenously on day 8. After 3 courses of chemotherapy, the primary lesion and the regional lymph nodes were significantly reduced in size. He was judged as clinical PR, followed by total gastrectomy, splenectomy and lymph node dissection. The pathological findings showed that there were very few cancer cells in the primary lesion, and lymph nodes had become scarred and fibrous. The final diagnosis was T2N0 H0 P0, fStageIB and curability A.

Matsui K, Nashimoto A, Nakagawa S, Nomura T, Yabusaki H, Takii Y, Tsuchiya Y, Tanaka O, Ohta T.

Dept. of Surgery, Niigata Cancer Center Hospital.