title: [Efficacy of the combination therapy in early stage of recurrent cholangio celluler carcinoma (CCC)].
abstract: We report a case of cholangio celluler carcinoma (CCC) with a good quality of life, in spite of the recurrence of peritoneum and portal hepatic lymph nodes (PHLN), due to the combination therapy that consisted of hepatic arterial infusion, systemic chemotherapy, radiation therapy and an insertion of a metallic stent into the bile duct. The patient was a 61-year-old man. Left hepatectomy was done due to multiple CCC. For the purpose of preventing the recurrence of CCC in residual liver, we performed an arterial infusion therapy. Ten months later, metastases to peritoneum and portal hepatic lymph nodes were found, so the resection of the peritoneum was performed, and cells in ascites were defined to be positive with cytology. After 2 years from the first operation, the size of portal hepatic lymph nodes had grown and both the billilbin and tumor marker levels had increased, so we started systemic chemotherapy, radiation therapy and insertion of a metallic stent into the bile duct. The tumor marker level decreased in a short time. Consequently, we inserted a metallic stent into the bile duct and radiation therapy was performed. Until the patient's death due to peritonitis carcinomatosa, the recurrence in residual liver occurred only once in three years after the first operation, and portal hepatic lymph nodes did not grow for two years after the recurrence.
authors.affiliation: Dept. of Surgery, Hyougo Prefectural Nishinomiya Hospital.
authors.forename: Shinichi
authors.initials: S
authors.lastname: Fujiwara
authors.forename: Yasunori
authors.initials: Y
authors.lastname: Hasuike
authors.forename: Nariaki
authors.initials: N
authors.lastname: Fukuchi
authors.forename: Nobuyasu
authors.initials: N
authors.lastname: Hayashi
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kida
authors.forename: Masaki
authors.initials: M
authors.lastname: Tsujie
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Yoshida
authors.forename: Chikara
authors.initials: C
authors.lastname: Ebisui
authors.forename: Isao
authors.initials: I
authors.lastname: Sakita
authors.forename: Takayoshi
authors.initials: T
authors.lastname: Fujimoto
mesh_terms: D001650:Bile Duct Neoplasms / Q000473:pathology / Q000628:therapy*; D001653:Bile Ducts, Intrahepatic; D018281:Cholangiocarcinoma / Q000473:pathology / Q000628:therapy*; D003131:Combined Modality Therapy; D006498:Hepatectomy; D006801:Humans; D007261:Infusions, Intra-Arterial; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control; D010537:Peritoneum / Q000601:surgery; D011786:Quality Control; D015607:Stents