[Chemotherapy and Conversion Surgery for Advanced Gastric Cancer Patient with a Liver Metastasis in 81 Years Old Woman].

Eighty-one year-old woman was pointed out pulmonary tumor by health check and transferred to our hospital. Her performance status was fine. In imaging study, she had advanced gastric cancer with a solitary liver metastasis and highly suspected left lung cancer. She received chemotherapy combined with oxaliplatin and S-1 as first-line. However, the tumor enlarged and then received second-line chemotherapy combined with paclitaxel and ramucirumab. The tumor shrank and a solitary liver metastasis remained. She underwent gastrectomy and partial hepatectomy. After conversion surgery, she had no chemotherapy and had survived over 5 years. Even in old person over 80 years old, chemotherapy and surgery are considerable in patients with well performance status.

Degree of Differentiation of Esophageal Squamous Cell Carcinoma and Micrometastasis to Lymph Nodes.

Objectives: The goal of the study was to examine the relationships among micrometastasis, pathological degree of differentiation and survival in patients with esophageal squamous cell carcinoma (SCC). Design: A single-center retrospective study of patients diagnosed with thoracic esophageal SCC. Methods: Immunostaining using CK13 was carried out for all lymph nodes resected by radical esophagectomy with three-field lymphadenectomy. The relationships among micrometastasis to lymph nodes, degree of differentiation and survival were investigated. Results: The 25 patients included 14 (56.0%) well-differentiated and 11 (44.0%) moderately differentiated cases. In multivariate analysis, well-differentiated cases were not related to micrometastasis (odds ratio (OR): 1.5, confidence interval (CI): 0.2-12, p=0.7). In multivariate analysis of survival, cases in pStage III or higher were likely to have shorter survival (hazard ratio (HR): 2.8, CI: 0.7-12, p=0.16), and those with micrometastasis also tended to have shorter survival (HR: 2.7, CI: 0.8-9, p=0.11)); however, well-differentiated cases were not significantly related to survival (HR: 1.5, CI: 0.4-5.5, p=0.5). Conclusion: Micrometastasis to lymph nodes may be a prognostic factor even in advanced esophageal cancer. The degree of differentiation was not related to micrometastasis or survival.