A 74-year-old male underwent left upper abdomen excision (LUAE) and D3 lymph node dissection for type 4 gastric cancer. Nine months after the surgery, abdominal computed tomography (CT) revealed paraportal lymph node recurrence (#8p), 22 mm in size. One hundred mg/body/day of TS-1 was administrated for 14 days, followed by 7 days rest, as one course. A complete response was obtained after the second course. This treatment was stopped after the 11 course because the patient suffered prolonged grade 1 fatigue. The patient has been in good health without a recurrence for 1 year and 5 months after the recurrence. Adverse effects included rash (grade 1), diarrhea (grade 2), fatigue (grade 2) and neutrophils neutropenia (grade 2).