s-1-(combination) and Gastric-Outlet-Obstruction

We evaluated the efficacy of gastrojejunostomy for advanced gastric cancer patients with peritoneal dissemination.. We evaluated the clinical outcome of 11 patients (average age 73.5 years for 8 men) who received gastrojejunostomy for gastric outlet obstruction caused by advanced gastric cancer with peritoneal dissemination between October 2003 and December 2008. We performed stomach-partitioning gastrojejunistomy with tube jejunostomy.. Three patients with performance status 3 and severe peritoneal dissemination deteriorated during the early postoperative days and were transferred to terminal care. These three patients died after 23, 26 and 60 days. The other 8 patients were discharged from hospital between 10 and 35 days postoperatively (median hospital stay 16 days) and received chemotherapy with S-1 on an outpatient basis. All patients died within one year except the one who showed a partial response to chemotherapy and lived for 40 months (MST: 8 months in all patients).. It seemed that there was little adaptation to gastrogejunostomy as palliation surgery for patients with poor performance status (PS 3) and severe peritoneal dissemination.

Topics: Aged; Aged, 80 and over; Antimetabolites, Antineoplastic; Drug Combinations; Female; Gastric Bypass; Gastric Outlet Obstruction; Humans; Male; Middle Aged; Oxonic Acid; Palliative Care; Peritoneal Neoplasms; Stomach Neoplasms; Tegafur; Treatment Outcome

We report a case of advanced gastric cancer with antral stenosis that responded to an oral anticancer agent, TS-1, after metallic stent insertion. A 59 year-old man was admitted to our hospital because of abdominal distension and vomiting after meals. The diagnosis was advanced gastric cancer with antral stenosis and multiple liver metastases. FP therapy (CDDP 80 mg/m2 day 1 div, 5-FU 700 mg/m2 day 1-5 continuous div) was administered. Although endoscopic findings showed improvement after the first course, the condition of the patient did not improve. We therefore inserted a self-expandable metallic stent into the antral stenosis. After implantation, the patient was able to have regular meals, leave the hospital and return to work. TS-1 (120 mg daily), an oral fluorouracil derivative, was administered in the outpatient setting. A partial response (PR) was obtained after 2 courses with regression of multiple liver metastases and the primary tumor.

Topics: Antimetabolites, Antineoplastic; Drug Combinations; Gastric Outlet Obstruction; Humans; Liver Neoplasms; Male; Middle Aged; Oxonic Acid; Pyridines; Stents; Stomach Neoplasms; Tegafur