[A Case of Squamous Cell Carcinoma of the Esophagus with Achalasia -- Conversion from Chemoradiotherapy to Surgery].

The patient was a 67-year-old woman with achalasia and squamous cell carcinoma(SCC)of the esophagus. She presented with a difficulty in swallowing. The cancer was on the surface of the esophagus. The patient initially received systemic chemotherapy with 5-FU and cisplatin, and radiation therapy. The difficulty in swallowing persisted due to insufficiency of radiation treatment caused by achalasia. Therefore, we shifted the treatment plan from chemoradiotherapy to surgery. Endoscopic examination performed before surgery showed that there was no obvious cancer in the esophagus. We resected the esophagus routinely. On the specimen, no cancer cells were detected upon macroscopic and microscopic examinations; metastasis was not detected in the lymph node. Achalasia is a recognized risk factor for esophageal SCC. In the treatment of superficial SCC, no difference of therapeutic effect was observed between surgery and chemoradiation. However, for the treatment of certain cases of SCC with achalasia, including the treatment of achalasia itself, surgery can be the preferred option of treatment.

[Clinical Response of Metastatic Colon Cancer to Chemotherapy with S-1 and Oxaliplatin - A Case Report].

Chemotherapy with S-1 and oxaliplatin is a new treatment for metastatic colorectal cancer. We present the first case of S-1, oxaliplatin, and bevacizumab therapy in our hospital. The patient was a 69-year-old woman with ascending colon cancer and multiple lung and liver metastases. She tended to suffer from constipation; stenoses at the cecum and colon cancer were detected by colon fiberscopy. Following surgical resection of the primary tumor, the patient received systemic chemotherapy with S-1, oxaliplatin, and bevacizumab. Following chemotherapy, CT showed no cancer in the lung and cancer reduction in the liver or dissemination. The patient had diarrhea and no appetite at first, so we reduced the oxaliplatin dose by 80%. After reduction of the oxaliplatin dose, we could treat the patient with S-1 and oxaliplatin continuously with no toxicity. S-1 and oxaliplatin chemotherapy is cost-effective, and has less toxicity than other chemotherapies, if proper measures are taken. It seemed to have a non-inferior response rate and disease control compared to other chemotherapies, such as FOLFOX. Thus, this chemotherapy is a valid choice for metastatic colorectal cancer.

[Clinicopathological features of young patients with triple negative breast cancer].

This study investigated triple negative diagnoses that occurred in 27 (11%) out of 243 cases of breast cancer analyzed for the presence of estrogen receptor (ER), progesterone receptor( PgR), and human epidermal growth factor receptor 2 (HER 2). In 5 of the triple negative cases of breast cancer, the patients were young, under 35 years of age (average age of 29). In 22 of the cases, the women were 35 years or older (average age of 66). The cancer quickly reoccurred in 4 of the 5 cases of triple negative breast cancer in young women despite various chemotherapy treatments, and in 3 of those cases the women died within 14 months following surgery. Even in statistical analysis, triple negative breast cancer in young women has a significantly poorer prognosis for both disease-free survival rate and overall survival rate, compared with triple negative breast cancer in women 35 and older, and young women without triple negative breast cancer. When basal-like phenotype was defined as being positive for epidermal growth factor (EGFR) and/or cytokeratin (CK)5/6, among the triple negative breast cancer cases of women 35 years and older, the rate for basal-like phenotype, which is said to have a poor prognosis, was 67% (14 out of 21 cases) while in young women with triple negative breast cancer, all cases (5 out of 5) were basal-like phenotype. This suggests that the biological degree of malignancy is extremely high for young women with triple negative breast cancer.