A Case of Advanced Gastric Cancer with Extensive Lymph Node Metastasis That Showed pCR to Preoperative Chemotherapy ContainingXP

A 67-year-old man was admitted to our hospital because of a type 2 tumor on the posterior wall of the cardia, and a biopsy resulted in a diagnosis of moderately differentiated tubular adenocarcinoma. Abdominal CT revealed swelling of the No. 1, 3, 11p(bulky N), and No.16a2lat lymph nodes. He was diagnosed with gastric cancer, T4aN2M1(LYM), cStage ⅣB, and was administered chemotherapy. After 2 courses of chemotherapy containing capecitabine plus cisplatin(XP), both the primary tumor and lymph nodes markedly decreased in size; then, total gastrectomy with D2+No.16a2lat was performed. Pathological examinations showed no residual cancer cells both in the primary lesion and lymph nodes; thus, the treatment effect of chemotherapy was Grade 3. Some gastric cancer patients may undergo curative resection even with extensive lymph node metastases when effective chemotherapy has been administered. Further discussions are needed about optimal chemotherapeutic regimens and surgical procedures.