A 55-year-old male patient with epigastralgia was diagnosed as type 3 gastric cancer at the lower gastric region. Total gastrectomy and D3 lymph node dissection were performed in our hospital. Pathological findings showed pT2N2M0, pStage IIIA. He was treated with 5'-DFUR and PSK therapy as adjuvant chemotherapy for 18 months after surgery. At 24 months after the operation, paraaortic lymph node recurrence was confirmed by computed tomography. He was treated with single agent S-1 in 10 courses on a 4-week dosing regimen with a 2-week interval. After 4 courses, CT showed a disappearance of paraaortic lymph node. He was obtained a complete response. Now the patient is disease-free for 11 years after operation.