Two cases of recurrent gastric cancer are described. Recurrence at anastomosis was detected following total gastrectomy in both patients. They declined surgery but wanted medical treatment. Therefore, 100 mg/kg of TS-1 was administered with informed consent. Symptoms related to stenosis were relieved after the first course, and complete responses were confirmed by endoscopic and pathological studies after completion of 4 courses in both patients. Palliative surgery remains a major option of treatments for patients with recurrence at anastomosis after total gastrectomy. TS-1, however, should be considered a treatment for such cases with satisfactory QOL, especially for outpatients who do not want surgery.

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