title: Successful curative resection of gallbladder cancer following S-1 chemotherapy: A case report and review of the literature.
abstract: The symptoms of gallbladder cancer (GBC) are vague and non-specific. Therefore, GBC is often detected at an advanced or metastatic stage. The most effective treatment for GBC is surgical resection, however the majority of GBC cases are unresectable at the time of diagnosis. Therefore, numerous GBC patients undergo chemotherapy. This study reports the case of a 60-year-old female with GBC who underwent successful surgical curative resection following a single dose of the chemotherapeutic agent, S-1, twice daily for 4 weeks followed by a 14-day rest period for 36 months. S-1 is a novel orally administered drug composed of a combination of the 5-fluorouracil (5-FU) prodrug, tegafur, 5-chloro-2,4-dihydroxypyridine (CDHP) and oteracil potassium in a 1:0.4:1 molar concentration ratio. The focus of the present study was the candidate factors that affect the therapeutic efficacy of S-1-based chemotherapy. In particular, the gene expression involved in the S-1 metabolic pathway was investigated by assessing the intratumoral dihydropyrimidine dehydrogenase (DPD),thymidylate synthase (TS) and orotate phosphoribosyltransferase gene expression. The surgical specimen exhibited high intratumoralDPDgene expression levels compared with those observed in previously reported non S-1 responsive cases of biliary tract cancer. Due to the results obtained in the current study, we hypothesize that CDHP enhanced the antitumor efficacy of 5-FU by inhibiting the excess DPD protein produced by the tumor.
authors.affiliation: Division of Gastroenterological and General Surgery, Asahikawa Medical University, Asahikawa, Hokkaido 078-8510, Japan ; Department of Surgery, Hokkaido Social Work Association Obihiro Hospital, Obihiro, Hokkaido 080-0805, Japan.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Einama
authors.affiliation: Division of Gastroenterological and General Surgery, Asahikawa Medical University, Asahikawa, Hokkaido 078-8510, Japan.
authors.forename: Koichiro
authors.initials: K
authors.lastname: Uchida
authors.affiliation: Division of Gastroenterological and General Surgery, Asahikawa Medical University, Asahikawa, Hokkaido 078-8510, Japan.
authors.forename: Masahiko
authors.initials: M
authors.lastname: Taniguchi
authors.affiliation: Division of Gastroenterological and General Surgery, Asahikawa Medical University, Asahikawa, Hokkaido 078-8510, Japan.
authors.forename: Yu
authors.initials: Y
authors.lastname: Ota
authors.affiliation: Division of Gastroenterological and General Surgery, Asahikawa Medical University, Asahikawa, Hokkaido 078-8510, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Watanabe
authors.affiliation: Division of Gastroenterological and General Surgery, Asahikawa Medical University, Asahikawa, Hokkaido 078-8510, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Imai
authors.affiliation: Division of Gastroenterological and General Surgery, Asahikawa Medical University, Asahikawa, Hokkaido 078-8510, Japan.
authors.forename: Hidenori
authors.initials: H
authors.lastname: Karasaki
authors.affiliation: Digestive Disease Center, Asahikawa City Hospital, Hokkaido 070-8610, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Chiba
authors.affiliation: Department of Surgical Pathology, Asahikawa Medical University, Asahikawa, Hokkaido 078-8510, Japan.
authors.forename: Kensuke
authors.initials: K
authors.lastname: Oikawa
authors.affiliation: Department of Surgical Pathology, Asahikawa Medical University, Asahikawa, Hokkaido 078-8510, Japan.
authors.forename: Naoyuki
authors.initials: N
authors.lastname: Miyokawa
authors.affiliation: Division of Gastroenterological and General Surgery, Asahikawa Medical University, Asahikawa, Hokkaido 078-8510, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Furukawa
keywords: S-1; gallbladder cancer; gene expression