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A 59-year-old woman had a history of distal gastrectomy and D2 dissection in May 200X for advanced gastric cancer(GC) in the antrum area. The pathological stage was poorly differentiated, T2(SS), N2, H0, P0, CY0, M0, pStage ⅢA. After administration of S-1 for 1 year as adjuvant chemotherapy, the patient underwent surveillance with no recurrence. However, remnant GC was diagnosed in April 200X+12. Considering that there was no indication for curative resection due to severe invasion of the proper hepatic artery, gastrojejunostomy was performed for the anastomotic stenosis. Although the patient was administered 3 courses of S-1 plus oxaliplatin therapy as first-line treatment, partial response was not achieved. Therefore, chemoradiotherapy(CRT)with capecitabine was administered for local tumor control. Complete response was achieved, and the patient underwent surveillance with no recurrence 16 months after the recurrence. There were no serious acute adverse events(AEs)during CRT and late AEs after CRT. The patient was successfully treated with CRT for locally advanced remnant GC. Although there is no standard treatment for locally advanced remnant GC, this case showed the effectiveness of CRT.

Postcontrast CT scan using multislice CT was performed in 10 patients prior to laparoscopic gastric cancer surgery. Using 16-detector multislice CT, images were obtained at both arterial and venous phases under a single breath-hold. Three-dimensional CT angiography at arterial and venous phases was respectively reconstructed using the volume-rendering technique and then fused. Multiphase fusion imaging was able to demonstrate clearly, simultaneously, and three-dimensionally the gastric arteries and veins without a respiratory gap. In conclusion, multiphase fusion images were considered to be very useful for the intraoperative navigation of laparoscopic gastric cancer surgery.

We evaluated the effect of combination therapy of trastuzumab and paclitaxel for metastatic breast carcinoma. Among the 23 metastatic breast carcinoma patients treated in our institution from September 2001 to December 2002, 10 (43%) patients were immunohistochemically positive for the HER2 protein. Four of these patients had bone, 3 had lung, 2 had liver and 1 had supraclavicular lymph node metastases. The combination chemotherapy for these 10 patients was evaluated as follows: CR in 1 patient, PR in 4, NC in 2, and PD in 3. Two patients with liver metastases showed remarkable tumor regression. Combination therapy did not have to be stopped in any of the patients due to side effects. These results show that combination therapy of trastuzumab and paclitaxel may be a useful treatment regimen for chemotherapy-resistant metastatic breast carcinoma patients.

Postcontrast CT scanning using multislice CT was performed for 20 patients with gastric cancer. Three-dimensional (3D) CT angiography of the arterial and venous phases was reconstructed using the volume-rendering technique and then fused. 3D-CT angiography showed the arteries and veins around the stomach, and multiphase fusion imaging was able to demonstrate clearly and three-dimensionally the gastric vascular anatomy. In conclusion, the multiphase fusion image was considered to be useful in the preoperative simulation of laparoscopic gastric cancer surgery.

Purpose: Laparoscopic colorectal surgery, while minimally invasive, is a complicated technique. Therefore, prior to this surgery, it is important to determine the anatomical information of colorectal cancer., Materials and Methods: Fifty-eight cases of patients with a confirmed diagnosis of colon cancer [caecal (n = 4), ascending colon (n = 6), transverse colon (n = 7), descending colon (n = 2), sigmoid colon (n = 22), and rectal (n = 17) cancer] were evaluated using multislice CT before laparoscopic surgery. CT examination was performed in an air-filled colorectum by colon fiberscopy. Contrast-enhanced images on multislice CT were obtained at arterial and venous phases. All images were reviewed on a workstation, and three-dimensional (3D) images of vessels, colorectum, cancer, and swollen lymph nodes were reconstructed by volume rendering and fused (integrated 3D imaging). We evaluated the usefulness of integrated 3D imaging with multislice CT for laparoscopic colorectal surgery., Results: Integrated 3D imaging demonstrated clearly the distribution of arteries feeding the colorectal cancer and the anatomical location of colorectal cancer and arterial and venous systems. Moreover, measurement of the distance between the aortic bifurcation and the origin of the inferior mesenteric artery and that between the base of the inferior mesenteric artery and the origin of the left colic artery on integrated 3D imaging contributed to safe, prompt ligation of the vessels and excision of lymph nodes., Conclusion: Integrated 3D imaging with multislice CT was useful for simulation of laparoscopic colorectal surgery.