Journal of Digestive Cancer Research

  • 제6권1호
  • /
  • Pages.40-44
  • /
  • 2018
  • /
  • 2950-9394(pISSN)
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  • 2950-9505(eISSN)
대한소화기암연구학회 (Korean Society of Gastrointestinal Cancer Research)
권호 표지

림프절 전이가 동반된 진행성 위암 환자에서 수술 전 항암요법으로 시행한 FOLFOX 치료로 완전 관해를 보인 1례

A Case of Complete Response with FOLFOX Based Neo-adjuvant Chemotherapy in Advanced Gastric Cancer with Lymph Node Metastasis

  • 김명희 (충남대학교 의과대학 내과학교실) ;
  • 정현용 (충남대학교 의과대학 내과학교실) ;
  • 문희석 (충남대학교 의과대학 내과학교실) ;
  • 성재규 (충남대학교 의과대학 내과학교실) ;
  • 강선형 (충남대학교 의과대학 내과학교실) ;
  • 김주석 (충남대학교 의과대학 내과학교실)
  • Myung Hee Kim (Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital) ;
  • Hyun Yong Jeong (Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital) ;
  • Hee Seok Moon (Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital) ;
  • Jae Kyu Sung (Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital) ;
  • Sun Hyun Kang (Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital) ;
  • Ju Seok Kim (Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital)
  • 투고 : 2018.05.28
  • 심사 : 2018.06.17
  • 발행 : 2018.06.30
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초록

국소적인 진행성 위암의 근치적인 치료는 수술이 첫 번째 방법이다. 하지만 위암을 진단받은 환자 중에서 약 30% 만이 수술이 가능한 진행성 위암으로 진단을 받으며 그 중 약 40-60% 만이 R0 절제술이 가능하다. 저자들은 위 주위 림프절과 복강 림프절, 장막을 침범한 진행성 위암을 진단받은 환자를 3주간의 수술 전 항암화학요법으로 치료하였고, 근치적인 목적으로 위 절제술을 시행하였다. 조직병리검사에서 완전히 괴사된 종양 조직을 관찰할 수 있었고, 수술 후 현재까지 3차례의 추가적인 전신 항암화학요법을 시행하고 있으며, 추적 복부 전산화단층촬영에서 재발을 시사하는 소견을 보이지 않았다.

A 77-year-old man presented with abdominal discomfort and was diagnosed as Borrmann type 3 advanced gastric cancer with multiple lymph node metastases. An abdominal computed tomography (CT) and positron emission tomography-computed tomography (PET-CT) showed AGC, clinical stage IIIC (T4aN3M0). We started neo-adjuvant chemotherapy with FOLFOX (5-fluorouracil (5-FU))+Leucovorin+Oxaliplatin). After 3 cycles of FOLFOX chemotherapy, follow-up endoscopy showed remarkable improvement. Primary lesion and metastatic lymph nodes decreased size on follow up computed tomography (CT). The patient underwent radical total gastrectomy with esophagojejunostomy and histopathology revealed no remnant malignant cells at previous primary cancer lesion. The patient has currently completed his 3 cycle of adjuvant chemotherapy without recurrence. After an abdominal CT response assessment, further course of therapy will be decided.

키워드

참고문헌

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