Authors: Yoshiro Aoki Yasushi Toh Junya Taomoto Yoshihisa Sakaguchi Takeshi Okamura
Publish Date: 2011/08/26
Volume: 41, Issue: 9, Pages: 1255-
Abstract
A 46yearold man was referred to us after he presented to his local physician complaining of difficulty eating Upper gastrointestinal endoscopy revealed a tumor at the esophagogastric junction EGJ and moderately differentiated adenocarcinoma was diagnosed from the biopsy findings Computed tomography CT showed apparent enlargement of the pretracheal lymph nodes the lymph nodes around the bilateral recurrent laryngeal nerves and the lower thoracic paraesophageal lymph nodes confirming metastasis Since the disease was far advanced esophagogastric cancer with marked lymph node metastases throughout the mediastinum curative resection would have been unlikely Thus he was commenced on systemic chemotherapy with cisplatin 90 mg/body day 8 + S1 120 mg/body/day given for 3 weeks followed by a 2week withdrawal Even after six cycles of chemotherapy over 8 months a complete response could not be achieved Finally we performed transthoracic subtotal esophagectomy with extensive lymph node dissection reconstructed using a gastric tube through a retrosternal route The patient remains recurrencefree 7 years later
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