Two Cases of Advanced Gastric Cancer in the Upper Portion of the Stomach with Laparoscopic Total Gastrectomy after Neoadjuvant Chemotherapy

Case 1: A 55-year-old woman was diagnosed with type 3 gastric cancer(U, post, 30 mm, por, cT4aN2M0)of cStage III B. She received 3 courses of a DOS regimen, which consisted of docetaxel, oxaliplatin, and S-1, as neoadjuvant chemotherapy (NAC). She subsequently underwent curative laparoscopic total gastrectomy with D2+No.16a2lat dissection, and resection of part of the right crus of the diaphragm, which was suspected to have cancer infiltration. S-1 was started as adjuvant chemotherapy 37 days after gastrectomy. The patient is alive without recurrence 6 months after surgery. Case 2: A 59-yearold man was diagnosed with type 3 gastric cancer(UM-E, less, 80 mm, por, cT4aN2M0)cStage III B. NACwith DOS was administered. After 3 courses of NACwere completed, we performed spleen-preserving curative laparoscopic total gastrectomy with D2+No.16a2lat dissection. S-1 was started as adjuvant chemotherapy 54 days after gastrectomy. The patient is alive without recurrence 6 months after surgery.