Abstract
We herein report two cases showing long-term complete remission (CR) in response to S-1 monotherapy. Case 1 was a 65-year-old male diagnosed with an advanced poorly differentiated adenocarcinoma of the stomach with paraaortic lymph node metastases, which disappeared after S-1 monotherapy. Subsequently a total gastrectomy was performed, and histological CR was evident. His progress is presently uneventful without recurrence 50 months after surgery. Case 2 was a 59-year-old female who underwent a total gastrectomy with a jejunal pouch. The resected tumor was a medullary type poorly differentiated adenocarcinoma infiltrating the serosa and involving the regional lymph nodes. One year after surgery, endoscopy revealed a recurrent tumor in the jejunal pouch. After the administration of S-1, this recurrent tumor completely disappeared, and she has since maintained CR for 39 months. These cases suggest that a subgroup of patients with advanced gastric cancer may attain CR with S-1 monotherapy.
Highlights
S-1 is an oral antitumor agent that exploits the biochemical modulation of 5-fluorouracil (FU) pharmacokinetics
We report two cases of advanced gastric cancer showing longterm complete remission (CR) after S-1 monotherapy
This report documents two cases of advanced gastric cancer showing long-term CR to S-1 monotherapy; In case 1, CR was histologically verified in the surgically resected stomach, and in case 2 this was presented for a suture line recurrence in the jejunal pouch
Summary
S-1 is an oral antitumor agent that exploits the biochemical modulation of 5-fluorouracil (FU) pharmacokinetics. The tumor was clinically diagnosed as stage IV (cT3, cN3, cH0, cP0, cM0) according to the general rules of the Japanese Classification of Gastric Carcinomas.[6] S-1 (TS-1®, Taiho Pharmaceutical Co., Ltd.) at a dose of 120 mg/day was administrated orally for four weeks, followed by a two-week period of no treatment (4-week regimen). This therapeutic schedule was thereafter repeated four times. Case 2 A 59-year-old female underwent a total gastrectomy with regional lymph node dissection and a jejunal pouch with Roux-en-Y reconstruction for a tumor (6.1 × 5.1 cm in size) in the upper corpus. The patient has been well without any evidence of recurrence for 39 months
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