A case of advanced gastric cancer with paraaortic lymph node metastasis reaching long-term survival by TS-1 treatment

A 62-year-old male patient with paraaortic lymph node metastasis of type 2 gastric cancer underwent distal gastrectomy with partial resection of transverse colon. MTX/5-FU sequential therapy was performed 5 times as adjuvant chemotherapy. After that TS-1 was administered on a 4-week dosing regimen with a 2-week interval between sessions. The patient regimen was discontinued temporarily because of thrombocytopenia. Therefore the schedule was changed to a 2-week dosing regimen with a 1-week interval between sessions at 2 years after operation. Paraaortic lymph node size was then checked by abdominal CT one or two times a year. The size showed no change for 3 years after operation. Then, 3 years and 3.5 years later, CT follow-up did not show paraaortic lymph node or other organ metastasis. We judged the effect of TS-1 was CR. Now the patient is disease-free at 4 years after operation.