title: [Progression of gastric cancer observed for three and a half years under S-1 administration].
abstract: A 60-year-old male patient noticed a sudden epigastric pain and visited our hospital for treatment. Active gastric ulcer was discovered by a routine gastrointestinal endoscopy. Moderately differenciated tubular adenocarcinoma was confirmed by biopsy and was advised to take surgical treatment. However, he refused to go on with gastrectomy and selected to take S-1 as an oral anti-tumor drug instead. Despite many approaches to convince the patient to have surgery, three and a half years passed. Macroscopic findings have changed from 0-IIc type to infiltrating advanced type cancer. Finally, we persuaded him to take a surgical resection, but peritoneal dissemination was evident. Using S-1 against gastric cancer is common. However, S-1 should not be used before another evidence-based curative treatment is available. Furthermore, drugs should have been changed to others, if not effective. A rare clinical course is discussed.
authors.affiliation: Dept. of Surgery, Setagaya Shimoda General Hospital.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Baba
authors.forename: Kantaro
authors.initials: K
authors.lastname: Suzuki
authors.forename: Yuka
authors.initials: Y
authors.lastname: Sawada
authors.forename: Mahito
authors.initials: M
authors.lastname: Shimoda
authors.forename: Shigeto
authors.initials: S
authors.lastname: Shimoda
authors.forename: Takeshi
authors.initials: T
authors.lastname: Nagahama
mesh_terms: D018450:Disease Progression; D004338:Drug Combinations; D005743:Gastrectomy; D005773:Gastroscopy; D006801:Humans; D008297:Male; D008875:Middle Aged; D010094:Oxonic Acid / Q000008:administration & dosage / Q000627:therapeutic use*; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000473:pathology* / Q000601:surgery; D005641:Tegafur / Q000008:administration & dosage / Q000627:therapeutic use*; D013997:Time Factors
chemical_list: D004338:Drug Combinations; C079198:S 1 (combination); D005641:Tegafur; D010094:Oxonic Acid