[A case of curative resection after downsizing chemotherapy in initially unresectable locally advanced intrahepatic cholangiocarcinoma].

Abstract

This case report describes an 83-year-old man with intrahepatic cholangiocarcinoma who was referred by a local hospital. Abdominal computed tomography (CT) showed a large tumor in hepatic segments 4, 5, and 8 involving the right hepatic vein and inferior vena cava, which is normally indicative of an unresectable locally advanced tumor. After systemic chemotherapy with gemcitabine and cisplatin, the observed decrease in the level of tumor marker suggested that the cancer was responding to treatment, while radiological findings showed the main tumor shrunk without the presence of distant metastases. Thus, hepatic left trisectionectomy with bile duct resection was performed after portal vein embolization. Pathological examination revealed negative margins (R0). Eighteen months after surgery, the patient is free of disease and shows no signs of recurrence. An initially unresectable, locally advanced biliary tract cancer may be down sized by chemotherapy, which makes radical resection possible, at least in a proportion of patients. This approach provides longer survival and may have a potential for disease eradication as a new multidisciplinary approach for patients with unresectable locally advanced biliary tract cancer.

• Authors: Yu Aoki, Takayuki Suzuki, Atsushi Kato, Hiroaki Shimizu, Masayuki Ohtsuka, Hideyuki Yoshitomi, Katsunori Furukawa, Tsukasa Takayashiki, Satoshi Kuboki, Shigetsugu Takano, Daiki Okamura, Daisuke Suzuki, Nozomu Sakai, Shingo Kagawa, Masaru Miyazaki
• Journal: Gan to kagaku ryoho. Cancer & chemotherapy (Gan To Kagaku Ryoho) Vol. 41 Issue 12 Pg. 1509-11 (Nov 2014) ISSN: 0385-0684 [Print] Japan
• PMID: 25731235 (Publication Type: Case Reports, English Abstract, Journal Article)

Chemical References

• Deoxycytidine
• Cisplatin
• Gemcitabine

Topics

• Aged, 80 and over
• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Bile Duct Neoplasms (blood supply, drug therapy, pathology, surgery)
• Bile Ducts, Intrahepatic (blood supply, pathology, surgery)
• Cholangiocarcinoma (blood supply, drug therapy, pathology, surgery)
• Cisplatin (administration & dosage)
• Combined Modality Therapy
• Deoxycytidine (administration & dosage, analogs & derivatives)
• Humans
• Male
• Neoplasm Invasiveness
• Gemcitabine