title: Curative Resection After Gemcitabine, Cisplatin and S-1 Chemotherapy for Initially Unresectable Biliary Duct Cancer: A Case Report.
abstract: A 68-year-old woman was diagnosed with unresectable upper bile duct cancer with suspected invasion of the right hepatic artery and para-aortic lymph node metastasis (T4N3M0, stage IVb). She underwent plastic stent placement for obstructive jaundice and enrolled in our phase I study for unresectable biliary tract cancer consisting of cisplatin (25 mg/m(2) i.v. for 120 min) followed by gemcitabine (1,000 mg/m(2) i.v. for 30 min) on days 1 and 8, and oral S-1 on alternate days. After 8 courses of neoadjuvant chemotherapy without adverse effects, computed tomography showed near-complete disappearance of the tumor of the upper bile duct and of swollen lymph nodes. She then underwent sub-total stomach-preserving pancreatico duodenectomy and lymph node dissection. The pathological stage was pT1N0M0, stage I. The patient made a satisfactory recovery, was discharged 29 days after operation, and remains free of disease at 3 months after the operation under adjuvant chemotherapy using S-1.
authors.affiliation: Department of Surgery, Jikei University School of Medicine, Tokyo, Japan k-furukawa@jikei.ac.jp.
authors.forename: Kenei
authors.initials: K
authors.lastname: Furukawa
authors.affiliation: Department of Surgery, Jikei University School of Medicine, Tokyo, Japan.
authors.forename: Tadashi
authors.initials: T
authors.lastname: Uwagawa
authors.affiliation: Department of Surgery, Jikei University School of Medicine, Tokyo, Japan.
authors.forename: Taro
authors.initials: T
authors.lastname: Sakamoto
authors.affiliation: Department of Surgery, Jikei University School of Medicine, Tokyo, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Shiba
authors.affiliation: Department of Surgery, Jikei University School of Medicine, Tokyo, Japan Department of Surgery, Mashiko Hospital, Saitama, Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Tsutsumi
authors.affiliation: Department of Surgery, Jikei University School of Medicine, Tokyo, Japan.
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Yanaga
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001661:Biliary Tract Neoplasms / Q000188:drug therapy* / Q000601:surgery; D017024:Chemotherapy, Adjuvant / Q000379:methods; D002945:Cisplatin / Q000008:administration & dosage; D017321:Clinical Trials, Phase I as Topic; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D004338:Drug Combinations; D005260:Female; D006801:Humans; D020360:Neoadjuvant Therapy / Q000379:methods; D010094:Oxonic Acid / Q000008:administration & dosage; D005641:Tegafur / Q000008:administration & dosage; D000093542:Gemcitabine
chemical_list: D004338:Drug Combinations; D003841:Deoxycytidine; C079198:S 1 (combination); D005641:Tegafur; D010094:Oxonic Acid; D002945:Cisplatin; D000093542:Gemcitabine
keywords: Biliary duct cancer; case report; neoadjuvant chemotherapy