A case of scirrhous gastric carcinoma with peritoneal dissemination which was treated by curative gastrectomy after S-1/CDDP chemotherapy

The present patient was a 53-year-old female diagnosed as gastric cancer with peritoneal dissemination by staging laparoscopy. She was treated with chemotherapy using S-1 (80 mg/body/day) and CDDP (80 mg/body/day, day 8) administered for 3 weeks followed by a drug-free 2 weeks, in five-week courses. Stable disease (SD) was obtained after six courses, and then she underwent second-staging laparoscopy. Because of disappearing peritoneal disseminated nodules both macroscopically and histologically, she underwent curative total gastrectomy with D2 lymph node dissection and reconstruction by the Roux-en Y method. The postoperative pathological findings showed T2 (se) N1M0, stage IIIa and chemotherapy effective evaluation demonstrated Grade 1b. Postoperatively, S-1/CDDP therapy was carried out, after two cycles she suffered from anorexia, and then S-1 only was given. Fourteen months later, peritoneal dissemination developed. Despite changes in the regimen such as docetaxel or CPT-11, she died 23 months after the initial gastrectomy.