[A case of advanced gastric remnant carcinoma with Virchow's metastasis treated with neoadjuvant chemotherapy (low dose CDDP + 5-FU) followed by surgical resection].

The patient was a 64-year-old woman. At hospitalization she had gastric remnant carcinoma with Virchow's and paraaortic lymph node metastases, extensive local infiltration and obstructive jaundice. The lesions were considered nonresectable, and the patient was placed on neoadjuvant chemotherapy consisting of low-dose CDDP and 5-FU, which resulted in the disappearance of Virchow's and paraaortic lymph node metastases. She was considered to have a partial response (PR) and underwent lower esophageal resection, total remnant gastrectomy and splenectomy. Eight months after surgery, however, she died of disseminated carcinomatosis of bone marrow. Since this therapy was associated with only slightly adverse events (< or = Grade 1), this treatment modality appears to be safe. However, further studies will be necessary to identify what type of recurrence is responsive to this therapy and to evaluate its effect on patient survival.