title: [Chemotherapy with gemcitabine after non-curative resection of bile duct cancer--a case report].
abstract: Non-curative resection for cholangiocarcinoma usually leads to a poor prognosis. We present a case successfully treated with gemcitabine for residual tumor after extra hepatic bile duct resection with positive surgical margin. The patient was a 77-year-old male who was diagnosed as having a common bile duct cancer. Extra hepatic bile duct resection was performed, but intraoperative pathology diagnosed the surgical margin of duodenal-side bile duct was positive for cancer. Although additional resection of bile duct was done, pathological diagnosis resulted in positive margin again. We had to avoid pancreatoduodenectomy in light of the patient's wishes, so a curative resection could not be carried out. Adjuvant chemotherapy with gemcitabine(800 mg/m2 on days 1, 8 and 15 every 4 weeks)was started at the seventh postoperative day. A residual lesion was shown in the pancreas head by abdominal CT after 2 courses of chemotherapy. Follow-up CT was performed every 6 months, and the lesion gradually seemed to become unclear. Finally, CT showed disappearance of the residual lesion 28 months after surgery. The chemotherapy has been continued up to the present(3 years and 5 months after surgery). No evidence of recurrence nor adverse events of WHO grade 2 or more has been observed.
authors.affiliation: Dept. of Surgery, Tokyo Women's Medical University Medical Center East.
authors.forename: Dal Ho
authors.initials: DH
authors.lastname: Kim
authors.forename: Shunichi
authors.initials: S
authors.lastname: Shiozawa
authors.forename: Akira
authors.initials: A
authors.lastname: Tsuchiya
authors.forename: Takebumi
authors.initials: T
authors.lastname: Usui
authors.forename: Satoshi
authors.initials: S
authors.lastname: Inose
authors.forename: Masaki
authors.initials: M
authors.lastname: Aizawa
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Yoshimatsu
authors.forename: Takao
authors.initials: T
authors.lastname: Katsube
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Naritaka
authors.forename: Kenji
authors.initials: K
authors.lastname: Ogawa
mesh_terms: D000368:Aged; D001650:Bile Duct Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology* / Q000601:surgery; D003841:Deoxycytidine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006801:Humans; D008297:Male; D014057:Tomography, X-Ray Computed; D000093542:Gemcitabine
chemical_list: D003841:Deoxycytidine; D000093542:Gemcitabine