title: [Complete response to S-1/CDDP combination in a patient with obstructive jaundice secondary to lymph node metastasis by gastric cancer - a case report].
abstract: A 55-year-old woman was found to have a type-4 lesion centered on the greater curvature of the lower portion of her stomach during an upper gastrointestinal endoscopic examination.A diagnosis of inoperable advanced gastric carcinoma [type 4, tub 2/por, T3 (SE), N3, H0, P1, cStage IV], complicated by pyloric stenosis, liver dysfunction, and obstructive jaundice untreatable by bile drainage, was made.After obtaining the informed consent of the patient and her family and explain- ing that under the circumstances surgery was not indicated, chemotherapy [S-1 (granules) 80 mg/m2, CDDP 60 mg/m2] was selected. After starting treatment, an improvement in liver dysfunction and jaundice was observed, and at the start of the second course, the patient had become capable of oral feeding.The patient was discharged after completion of the second course. No choices associated with evidence exist for treatment of patients with inoperable advanced gastric cancer (complicated by obstructive jaundice), who are not elderly and have good performance status (PS).We report this case in which improvement of activity of daily living (ADL) was achieved relatively safely by treatment with S-1/CDDP, together with a brief discussion based on the literature.
authors.affiliation: Dept. of Gastroenterological Surgery, Showa University Fujigaoka Hospital, Japan.
authors.forename: Tetsuhiro
authors.initials: T
authors.lastname: Goto
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Nemoto
authors.forename: Kazuki
authors.initials: K
authors.lastname: Shinmura
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Yokomizo
authors.forename: Youhei
authors.initials: Y
authors.lastname: Kitamura
authors.forename: Kazuma
authors.initials: K
authors.lastname: Sakuraba
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Soda
authors.forename: Taketo
authors.initials: T
authors.lastname: Matsubara
authors.forename: Mitsuo
authors.initials: M
authors.lastname: Saito
authors.forename: Kazuyoshi
authors.initials: K
authors.lastname: Ishibashi
authors.forename: Gaku
authors.initials: G
authors.lastname: Kigawa
authors.forename: Kenji
authors.initials: K
authors.lastname: Hibi
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002945:Cisplatin / Q000008:administration & dosage / Q000627:therapeutic use*; D004338:Drug Combinations; D005260:Female; D006801:Humans; D041781:Jaundice, Obstructive / Q000209:etiology*; D008207:Lymphatic Metastasis; D008875:Middle Aged; D010094:Oxonic Acid / Q000008:administration & dosage / Q000627:therapeutic use*; D013274:Stomach Neoplasms / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D005641:Tegafur / Q000008:administration & dosage / Q000627:therapeutic use*
chemical_list: D004338:Drug Combinations; C079198:S 1 (combination); D005641:Tegafur; D010094:Oxonic Acid; D002945:Cisplatin