title: [A case of long-term survival after aggressive surgery for Stage IV gallbladder carcinoma].
abstract: A 67-year-old woman was referred to our hospital because of a gallbladder mass. Abdominal computed tomography revealed a protruding mass 34 mm in diameter in the body of the gallbladder with wall thickening and enhancement. Advanced gallbladder carcinoma was diagnosed by image analysis, with liver metastasis in segment 5 and lymph node metastasis in the hepatoduodenal ligament. Subsequently, S4a+S5 hepatic segmentectomy was performed with extrahepatic bile duct resection and regional lymphadenectomy. The final pathological diagnosis was pT2 pN1 pM1, Stage IV,according to the International Union against Cancer classification system. Curative resection was then performed. In addition, we performed adjuvant chemotherapy with 15 courses of 1,000 mg/m2 gemcitabine on days 1, 8, and 15 at every 28 days. At 5 years after the operation, the patient was alive and free of disease. Therefore, in cases of limited liver metastasis (within segments 4a and 5), aggressive surgery should be considered even for Stage IV gallbladder carcinoma. In such cases, long-term patient survival may be expected only when curative resection is achieved.
authors.affiliation: Dept. of Surgery, Kimitsu Chuo Hospital.
authors.forename: Kazuyasu
authors.initials: K
authors.lastname: Shinmura
authors.forename: Takashi
authors.initials: T
authors.lastname: Kaiho
authors.forename: Shinji
authors.initials: S
authors.lastname: Yanagisawa
authors.forename: Ryo
authors.initials: R
authors.lastname: Okamoto
authors.forename: Masaki
authors.initials: M
authors.lastname: Nishimura
authors.forename: Soichi
authors.initials: S
authors.lastname: Kobayashi
authors.forename: Akira
authors.initials: A
authors.lastname: Okaniwa
authors.forename: Satoru
authors.initials: S
authors.lastname: Nomura
authors.forename: Shunichi
authors.initials: S
authors.lastname: Tsuchiya
authors.forename: Masaru
authors.initials: M
authors.lastname: Miyazaki
mesh_terms: D000368:Aged; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use; D017024:Chemotherapy, Adjuvant; D003841:Deoxycytidine / Q000031:analogs & derivatives / Q000627:therapeutic use; D005260:Female; D005706:Gallbladder Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008113:Liver Neoplasms / Q000188:drug therapy / Q000556:secondary / Q000601:surgery; D009367:Neoplasm Staging; D000093542:Gemcitabine
chemical_list: D000964:Antimetabolites, Antineoplastic; D003841:Deoxycytidine; D000093542:Gemcitabine