[A case of T4 esophageal squamous cell carcinoma in esophagogastric junction effectively treated by neoadjuvant FAP therapy].

A 59-year-old man was admitted to our hospital because of vomiting and body weight loss. Upper GI series and upper digestive tract endoscopy revealed type 3 cancer lesion in the area from the lower thoracic esophagus to the middle gastric body. In the biopsy specimen squamous cell cancer was shown. We perfomed neoadjuvant chemotherapy because the computed tomography revealed invasion to the diaphragm and aorta. After chemotherapy a 65% reduction was obtained, and we performed total gastrectomy with lower esophagectomy and lower mediastinal and abdominal lymph node dissection and Roux-en Y reconstruction in the left thoracoabdominal serial incision. In the histological examination, Grade 1 response was obtained in the primary specimen and Grade 3 response in the lymph node specimens. In the 44 months since surgery, the patient has remained well and disease free. It was suggested that a combination of neoadjuvant chemotherapy and surgery was successful treatment for this case.