{"created":"2023-06-19T08:46:41.178790+00:00","id":2263,"links":{},"metadata":{"_buckets":{"deposit":"6b6fa21f-ad49-46f7-8784-fc4f44c1dea8"},"_deposit":{"created_by":25,"id":"2263","owners":[25],"pid":{"revision_id":0,"type":"depid","value":"2263"},"status":"published"},"_oai":{"id":"oai:ycu.repo.nii.ac.jp:00002263","sets":["4","4:71:453:454"]},"author_link":["4142","4143","4144","4145","4146","4147","4148","4149","4150","4151","4152","4153","4154","4155","4156","4157","4158","4159","4160","4161","4162","4163"],"control_number":"2263","item_10002_biblio_info_7":{"attribute_name":"bibliographic_information","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2021-01-30","bibliographicIssueDateType":"Issued"},"bibliographicIssueNumber":"1","bibliographicPageEnd":"14","bibliographicPageStart":"9","bibliographicVolumeNumber":"72","bibliographic_titles":[{"bibliographic_title":"横浜医学"},{"bibliographic_title":"YOKOHAMA MEDICAL JOURNAL","bibliographic_titleLang":"en"}]}]},"item_10002_description_5":{"attribute_name":"抄録","attribute_value_mlt":[{"subitem_description":"症例は57歳男性．検診異常に対し施行した上部消化管内視鏡で胃癌が疑われ，当科紹介となった．精査の結果，上部消化管内視鏡で胃体中下部小弯に 2 型病変を認め，また腹部造影CTで胃病変と一塊となった多数のリンパ節腫大と腹部造影MRIで多発肝転移（S6，S7）を認めた．LM，Less，Type2，46㎜，pap-tub1-tub2，HER2 score3，cT4aN2（bulky N）H1（M1 HEP）P0CY0，cStageⅣの切除不能進行胃癌と診断し，XP＋trastuzumab （capecitabine 1500㎎/㎡ 1 日 2 回14日間，CDDP 80㎎/㎡/日day 1 投与，trastuzumab 8 ㎎/㎏day 1 投与： 3 週 1 コース）併用化学療法を施行した．腎障害のため 3 コース目からCDDPは中止としたが， 1 コース施行後にPR， 6 コース施行後にPET-CTで原発巣，リンパ節転移，肝転移はいずれも集積を認めずCRと判定し，ycT3（SS）N0M0，ycStageⅡAと診断した．Conversion Surgeryの適応として，開腹幽門側胃切除，D 2 郭清，oux-en-Y再建術を施行した．\n術後病理診断では化学療法の組織学的効果判定はGrade 3であった．術後補助化学療法としてX＋trastuzumaを 4 コース施行したが，術後 2 年 3 か月無再発生存中である．Conversion Surgeryの適切なタイミング，適格基準については一定の見解は得られていないが，今後の症例の蓄積，検討や前向き研究によりさらなる予後改善が期待される．","subitem_description_type":"Abstract"}]},"item_10002_identifier_registration":{"attribute_name":"identifier_registration","attribute_value_mlt":[{"subitem_identifier_reg_text":"10.15015/00002114","subitem_identifier_reg_type":"JaLC"}]},"item_10002_publisher_8":{"attribute_name":"出版者","attribute_value_mlt":[{"subitem_publisher":"横浜市立大学医学会"}]},"item_10002_source_id_9":{"attribute_name":"item_10002_source_id_9","attribute_value_mlt":[{"subitem_source_identifier":"0372-7726","subitem_source_identifier_type":"ISSN"}]},"item_creator":{"attribute_name":"著者","attribute_type":"creator","attribute_value_mlt":[{"creatorNames":[{"creatorName":"河原, 慎之輔","creatorNameLang":"ja"},{"creatorName":"カワハラ, シンノスケ","creatorNameLang":"ja-Kana"}],"nameIdentifiers":[{"nameIdentifier":"4142","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"青山, 徹","creatorNameLang":"ja"},{"creatorName":"アオヤマ, 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