Advanced ampullary carcinoma showing complete response to S-1: report of a case

We report a case of advanced ampullary carcinoma with para-aortic lymph node metastasis, which showed a complete response to S-1. The patient underwent cholecystectomy and Roux-en-Y choledochojejunostomy, and was then given S-1 orally 80 mg daily for 14 days, followed by 7 days of rest. After four cycles of the S-1 chemotherapy, both the tumor and the swollen paraaortic lymph node had completely disappeared. An additional six cycles were given at the request of the patient. No adverse effects were seen during the S-1 chemotherapy, and the patient has been free of the disease for the 27 months since its completion. Thus, S-1 monotherapy may be considered as a chemotherapeutic strategy for unresectable ampullary carcinoma, although large-scale studies will be required to confirm its true efficacy.