title: A salvage treatment for solid liver metastasis after radical resection of Klatskin tumour.
abstract: BACKGROUND
  Long-term survival has not been described following surgical resection for liver metastasis after radical resection of an advanced hilar bile duct carcinoma (Klatskin tumour). One such patient who developed liver metastasis after radical treatment for stage IVA (pTNM) hilar cholangiocarcinoma has survived 5.5 years after resection of the liver metastasis followed by chemotherapy.
  
  
  METHODS
  A 50-year-old man developed a solid liver metastasis in segment VIII 17 months after radical resection of a stage IVA (pT3 pN I MO) Klatskin tumour followed by postoperative radiotherapy (54 Gy) and systemic chemotherapy (oral UFT 450 mg/day plus intravenous cisplatin 20 mg on 5 consecutive days each month). The patient is alive at 7 years after the primary resection followed by resection of the liver metastasis plus further systemic chemotherapy comprising oral UFT combined with intravenous adriamycin (ADM) and mitomycin C (MMC).
  
  
  CONCLUSIONS
  Aggressive salvage resection surgery can be an effective component of a multidisciplinary treatment regimen, even for a postoperative liver metastasis that developed after radical resection of an advanced Klatskin tumour, provided that the metastasis is solid and has not failed local-regional control.
authors.affiliation: Department of Gastroenterological and Hepatobiliary Surgery, Graduate School of Comprehensive Human Sciences, University ot Tsukuba, Tsukuba-Shi, Japan.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Nakagawa
authors.forename: Takeshi
authors.initials: T
authors.lastname: Todoroki
authors.forename: Tadashi
authors.initials: T
authors.lastname: Kondo
authors.forename: Toru
authors.initials: T
authors.lastname: Kawamoto
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Ohkohchi
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Ohara