Evaluation of pre-operative chemotherapy with S-1 plus CDDP against advanced gastric cancer with paraaortic lymph node metastasis

We evaluated the effectiveness of pre-operative chemotherapy with S-1 plus CDDP against advanced gastric cancer with paraaortic lymph node metastasis. 8 patients received pre-operative chemotherapy with S-1 plus CDDP, according to the following regimen: S-1, 80 mg/m(2), was administered for 21 consecutive days followed by a 14-day rest period, and CDDP, 60 mg/m(2), was administered on day 8. The adverse event rate was 50%. However, a grade greater than 3 was not revealed. There were 5 partial responses (PR) and 3 stable diseases (SD). We performed 7 total gastrectomies and one distal gastrectomy, and the surgical curability (cur) resulted in 6 cases of cur B and two cases of cur C. The histological antitumor effect was grade 2 in three cases. The median overall survival rate was 623 days and the one-year survival rate was 75%. Analyzing for overall survival with antitumor effect and operative curability, both groups of PR and cur B prolonged survival. Pre-operative chemotherapy with S-1 plus CDDP, when used against advanced gastric cancer with paraaortic lymph node metastasis, might be an effective treatment.