[Two cases of stage IV gastric cancer who underwent total gastrectomy and achieved long-term survival by sequential chemotherapy].

We describe two patients, who suffered from Stage IV gastric poorly differentiated adenocarcinoma and underwent palliative total gastrectomy, were treated by sequential chemotherapy and achieved long term-survival. The first patient was a 55-year-old male with peritoneal dissemination. After total gastrectomy, he was treated with methotrexate-5-fluorouracil (MTX/5-FU) sequential therapy for 5 months, S-1 single-agent therapy for 4 years and weekly paclitaxel (PTX) therapy for 9 months. He is being treated with irinotecan (CPT-11) therapy as an outpatient now, and has achieved 5 year 8-month survival. The second patient was a 60-year-old female. We observed unresectable metastases around the pancreas, aorta, and transverse mesocolon. She was treated with S-1 single-agent therapy for 1 year 10 months, MTX/5-FU sequential therapy for 9 months. She is now receiving weekly PTX therapy for 3 months as an outpatient and has achieved 2 year 11-month survival.