Complete response of highly advanced gastric cancer with peritoneal dissemination after new combined chemotherapy of S-1 and low-dose cisplatin: Report of a case

TS-1((R)) (S-1) has been developed as a new oral anticancer drug based on t he biological modulation of 5-fluorouracil. We treated a patient with highl y advanced gastric carcinoma with a new combination chemotherapy of S-1 and low-dose cisplatin. Remarkable tumor reduction was observed after two cycl es of this therapy in the primary tumor and metastatic lymph nodes, and the ascites disappeared. This was concluded to be a partial response. The only adverse effect was skin pigmentation of the fingers (grade 1), leading to early timing of operation after chemotherapy. The gastric tumor showed evid ent invasion to the serosa. Lymph nodes around the stomach were swollen. Pe ritoneal dissemination was also recognized in the omentum and mesocolon. To tal gastrectomy with regional lymph node dissection was performed. Dissemin ated tumors were all resected. Histological examination showed that no tumo r cells were detected in the gastric primary lesion, metastatic lymph nodes or disseminated peritoneal tumors, suggesting pathological complete remiss ion. It was suggested that this regimen could be a potent combined therapy for the treatment of patients with highly advanced gastric carcinoma, and i t could be useful as neoadjuvant chemotherapy. Further studies are necessar y to evaluate the efficacy of this therapy. Copyright (C) 2001 S. Karger AG , Basel.