title: Lacrimal drainage obstruction in gastric cancer patients receiving S-1 chemotherapy.
abstract: BACKGROUND
  This study was conducted to determine the incidence and clinical characteristics of lacrimal drainage obstruction (LDO) in patients receiving S-1 chemotherapy.
  
  
  METHODS
  Consecutive 170 patients with gastric cancer who underwent curative surgery and received adjuvant S-1 chemotherapy were enrolled. S-1 was administered orally (40 mg/m2 b.i.d. on days 1-28 every 6 weeks) for 1 year. Ophthalmologic examinations were carried out on patients complaining of epiphora.
  
  
  RESULTS
  Thirty-one patients (18%) developed epiphora. Among 31 patients, 25 underwent ophthalmologic examinations and 22 (88%) were diagnosed with LDO. The median time to the onset of LDO was 2.9 months. The most common site of obstruction was the nasolacrimal duct [86% (19/22)]; punctal [23% (5/22)] and canalicular obstruction [14% (3/22)] were also noted. In multivariate analysis, total gastrectomy [versus partial gastrectomy: hazard ratio (HR), 2.9; P=0.014] and creatinine clearance<50 ml/min (versus ≥50 ml/min: HR, 2.9; P=0.038) were independent risk factors for the development of LDO.
  
  
  CONCLUSIONS
  Considering the high incidence of LDO in patients receiving S-1 chemotherapy, oncologists should be alert to epiphora and cooperate with ophthalmologists in the early stages to improve the quality of life of patients and avoid more complicated ophthalmologic procedures.
authors.affiliation: Department of Ophthalmology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam.
authors.forename: N
authors.initials: N
authors.lastname: Kim
authors.affiliation: Department of Ophthalmology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul.
authors.forename: C
authors.initials: C
authors.lastname: Park
authors.affiliation: Department of Surgery.
authors.forename: D J
authors.initials: DJ
authors.lastname: Park
authors.affiliation: Department of Surgery.
authors.forename: H-H
authors.initials: HH
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam; Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul.
authors.forename: S
authors.initials: S
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam.
authors.forename: Y J
authors.initials: YJ
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam.
authors.forename: J H
authors.initials: JH
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam.
authors.forename: J S
authors.initials: JS
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul.
authors.forename: Y-J
authors.initials: YJ
authors.lastname: Bang
authors.affiliation: Department of Ophthalmology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul.
authors.forename: S I
authors.initials: SI
authors.lastname: Khwarg
authors.affiliation: Department of Ophthalmology, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine, Seoul.
authors.forename: H
authors.initials: H
authors.lastname: Choung
authors.affiliation: Department of Ophthalmology, Hallym University Sacred Heart Hospital, Anyang, Korea.
authors.forename: M J
authors.initials: MJ
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam. Electronic address: hmodoctor@hanmail.net.
authors.forename: K-W
authors.initials: KW
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage / Q000009:adverse effects; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects*; D004338:Drug Combinations; D005260:Female; D006801:Humans; D007767:Lacrimal Duct Obstruction / Q000139:chemically induced* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009301:Nasolacrimal Duct / Q000187:drug effects / Q000473:pathology; D010094:Oxonic Acid / Q000008:administration & dosage / Q000009:adverse effects*; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000601:surgery; D005641:Tegafur / Q000008:administration & dosage / Q000009:adverse effects*
chemical_list: D000964:Antimetabolites, Antineoplastic; D004338:Drug Combinations; C079198:S 1 (combination); D005641:Tegafur; D010094:Oxonic Acid