A 7 9-year-old man with advanced
gallbladder cancer (stage IVa) underwent
chemotherapy with single-agent
gemcitabine (1,400mg/body: day 1, 8, 15, every 4 weeks) as first-line
chemotherapy. As soon as the
chemotherapy started, the
carbohydrate antigen 19-9 (CA19-9) level was notably reduced, and after 4 courses, CT scan revealed that the
tumor was markedly reduced in size. We thought he could undergo curative operation, and performed and extended
cholecystectomy and
lymph node dissection. Intraoperative findings revealed that the gallbladder atrophied and, with no obvious invasion to adjacent organs, a small hard mass like only
fibrosis was confirmed. Then, 18 days after the operation, he was discharged without any complication. In the histological findings,
cancer tissue was replaced by
fibrosis, and malignant cells could not be detected. Now the patient has remained well without recurrence after 6-month follow-up. Many clinical trials show that
gemcitabine, which is used as a single agent or combined with other agents (for example,
cisplatin), demonstrated high efficacy with manageable toxicity in patients with advanced or metastatic
biliary tract cancer. For this disease, including
gallbladder cancer,
gemcitabine is the mainstay of
chemotherapy, and it is thought that this agent could have high efficacy in many cases.