[A case of rectal cancer which showed complete response to chemotherapy for para-aortic lymph node metastases remaining after surgery, for which resection of Virchow's lymph node recurrence led to long-term survival].

A 55-year-old man with a positive fecal occult blood test visited our department, and after a thorough medical evaluation, was diagnosed with Stage IV Rs rectal cancer with marked para-aortic lymph node metastasis. In December 2007, the patient underwent low anterior rectal resection with D3 lymph node dissection, but the para-aortic lymph nodes were left. The metastatic lymph nodes showed a complete response(CR)to post-operative chemotherapy with FOLFOX, FOLFIRI, IRIS, and irinotecan+cetuximab, and the complete response was sustained for 18 months after surgery. Later, he developed Virchow's lymph node metastasis, which was also resected. At present, 5 years after the first surgery, the patient, whose chemotherapy has been discontinued, is alive without recurrence. It appears that using key drugs, such as 5-fluorouracil, leukovorin, oxaliplatin, irinotecan, and cetuximab, and performing aggressive salvage surgery for Virchow's lymph node recurrence, led to long-term recurrence-free survival.

[Combination chemotherapy study of biweekly paclitaxel and S-1 administration in patients with advanced gastric cancer].

In the present article, we report the results of phase I/II combination chemotherapy study of biweekly paclitaxel and S-1 administration in patients with advanced gastric cancer. In the phase I study, we could determine the recommended dose for the phase II study with paclitaxel and S-1 to be 120 mg/m2 and 80 mg/m2, respectively. The side effect was not so severe. The overall response was 53%. In conclusion, biweekly paclitaxel and S-1 administration can be safely combined for the treatment of advanced gastric cancer. This combined therapy represents a novel and active treatment regimen with low toxicity and can be defined as safe and effective. Now we are analyzing the result of the phase II study.

[Lymph nodes mapping for detection of sentinel nodes in patients with papillary thyroid cancer].

We examined the feasibility of sentinel lymph node biopsy for papillary thyroid cancer. In the dye injection method, 1% of isosulfan blue dye was injected around the tumor of 32 patients intra-operatively, and in the radioisotope (RI) colloid injection method, 99mTc-tin colloid was injected in 23 patients 1 day preoperatively. Lymph node mapping for detection of sentinel nodes was performed after thyroidectomy and central and modified lateral neck lymph node dissections. All dissected nodes were examined postoperatively by hematoxylineosin staining to determine whether or not metastasis was present. In the dye injection method, sentinel lymph nodes were identified in 30 (94%) of the 32 patients. Lymph node metastases were found in 14 patients, and some sentinel lymph nodes had papillary cancer metastasis in 13 patients. There was only 1 false-negative case. Sensitivity and accuracy of sentinel lymph node biopsy was 93% (13/14) and 97% (29/30). With the RI method, detection rate, sensitivity and accuracy of sentinel lymph node biopsy was 96% (22/23), 90% (9/10) and 95% (21/22), respectively. Our preliminary study indicated that sentinel lymph node biopsy was feasible in patients with thyroid cancer. It may be helpful in avoiding unnecessary lymph node dissection and improving quality of life in patients with thyroid cancer.