Case 1: A man in his sixties underwent extended right lobectomy of the liver for hepatic
hilar cholangiocarcinoma (stage III, fCur B)in July2002. CT scans revealed cancerous
pleuritis in March 2005, and he was treated with the
chemotherapy of GEM alone as first-line, combined
chemotherapy of S-1 and GEM as second-line, and CDDP and GEM as third-line treatment. These
therapies have been effective for about 20 months. Case 2: A woman in her sixties was diagnosed with advanced
gallbladder cancer(stage IVb)in September 2005. She was given combined
chemotherapy of S-1+GEM as first-line, and CDDP+GEM as second-line treatment. The main
tumor and metastatic lymph nodes were shrunk, allowing us to perform extended
hepatectomy. Histopathologic examinations of the resected specimen of the liver involved by the
tumor showed the increased infiltration of inflammatorycells and
fibrosis. These patients have been managed on an outpatient basis with good QOL and
cancer controlled. Although there has been no established standard regimen, the combined
chemotherapy based on GEM will be a provisional standard regimen for patients with advanced biliarytract
cancers.