A 64-year-old @entity1 visited our hospital complaining of @entity158 . An upper gastrointestinal endoscopy revealed @entity356 at the lower portion of the lesser curvature of the stomach. We performed a distal gastrectomy with D2 dissection. The histopathological diagnosis was well-differentiated @entity420 , mp, ly2, v0, n2(+), No. 11p(1/ 1), Stage III a.We used postoperative chemotherapy with a combination of S-1(80 mg/body)and low-dose @entity900 (10mg/ body   10 days). After 1 course, we continued only S-1(80 mg/body)for 3 weeks followed by a 2-week interval. About 1 year after the operation, the @entity478 value was abnormally high. An abdominal CT scan showed a marked swelling of the paraaortic lymph node. The @entity1 was then treated with the same protocol of S-1 and @entity900 again, but the @entity478 value did not decrease; therefore, a para-aortic lymph node dissection(No. 16a2b1 latero)was performed. Although the @entity478 value had decreased to normal, a few months later it was high again, and so we increased the S-1 dosage from 80 mg/body to 100mg/ body. But 6 months after the first para-aortic lymph node dissection, positron emission tomography(PET)revealed a swelling of paraaortic lymph node below the first recurrence site again. We changed the postoperative chemotherapy from S-1 and @entity900 to S-1(100mg/body)and irinotecan(80 mg/m   day 1, 8). Since the @entity478 value was not decreased, we performed a second para-aortic lymph node dissection(No. 16b1b2 latero)13 months after the first dissection. The @entity1 is presently alive with no signs of recurrence after over 1. 5 years. Para-aortic lymph node dissection combined with postoperative chemotherapy appeared to be effective for para-aortic lymph node @entity3 in this case.

[Efficacy of chemotherapy combined with dissection of para-aortic lymph node @entity3 following XXXX surgery -- case report].

@entity1 :: ('9606', 'Species') :: ['patient', 'man'] @entity478 :: ('5670', 'Gene') :: ['CEA'] @entity900 :: ('MESH:D002945', 'Chemical') :: ['cisplatin'] @entity158 :: ('MESH:D010146', 'Disease') :: ['epigastric pain'] @entity3 :: ('MESH:D009362', 'Disease') :: ['metastasis'] @entity420 :: ('MESH:D000230', 'Disease') :: ['tubular adenocarcinoma'] @entity356 :: ('MESH:D013274', 'Disease') :: ['a type 2 gastric cancer']
@entity356 :: (MESH:D013274,Disease) :: ['gastric cancer']
