[A case of unresectable gastric cancer presenting pylorus stenosis treated orally with S-1 therapy after gastrojejunostomy].

We reported a case of unresectable gastric cancer presenting pylorus stenosis treated orally by S-1 therapy in a 72-year-old man who underwent gastrojejunostomy. He was admitted to our hospital complaining of appetite loss and body weight loss. Detailed examination showed gastric cancer with pylorus stenosis. After insertion of the naso-gastric tube with washing, a laparotomy was done. The operative findings revealed sT3, sN2, sP1, sH0 and sM1 (metastases of No. 14a lymph nodes invading the super mesenteric artery and pancreas) as an unresectable case with stage IV. Gastrojejunostomy and Braun anastomosis were made through the antecolic route. After the operation, intake therapy of S-1 was started (80-100 mg/body/dayx28 days). After 2 courses of the therapy, gastrointestinal fiber showed clinically a partial response of the main tumor. After 3 courses of this treatment, the tumor presented multiple liver metastases as a clinically progressive disease state. Paclitaxel therapy was conducted at a dose of 80 mg/body/weekx3 timesx2 courses. The patient had no effective benefits from the treatment and died of the cancer. He had survived 9 months, and the intervals of the intake and home stay were 7.5 months and five months, respectively, after the operation with no side effect of the chemotherapy. Survival was no longer than for patients only operated without S-1 therapy.