title: [A Case of Successful Curative Resection Following Downsizing Chemotherapy in Initially Unresectable Locally Advanced Gallbladder Carcinoma].
abstract: A 58-year-old woman was referred to our hospital with high fever and right upper abdominal pain. Abdominal computed tomography (CT) revealed a bulky tumor of the gallbladder with liver invasion, metastases to para-aortic lymph nodes, and extensive infiltration to Glisson's sheath. The tumor was initially considered to be unresectable locally advanced gallbladder carcinoma with inflammation, and she received 6 courses of chemotherapy with gemcitabine plus cisplatin. Subsequently, the inflammation was extinguished, and CT showed the main tumor shrunk and the Glisson's sheath infiltration disappeared; however, a liver metastasis existed in segment 5. Thus, S4a plus S5 hepatic segmentectomy with extrahepatic bile duct resection and regional and para-aortic lymphadenectomy was performed. The pathological diagnosis was pT3a, pN1, pM1 (Hep, LYM), fStage ⅣB. Curative resection was then performed. If selected according to their response to downsizing chemotherapy, conversion therapy might therefore be an effective multidisciplinary treatment for patients with initially unresectable locally advanced gallbladder carcinoma.
authors.affiliation: Dept. of Surgery, Saitama Red Cross 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: Yangi
authors.initials: Y
authors.lastname: Mun
authors.forename: Shunichi
authors.initials: S
authors.lastname: Tsuchiya
authors.forename: Ryoji
authors.initials: R
authors.lastname: Chiba
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D005260:Female; D005706:Gallbladder Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D006801:Humans; D008113:Liver Neoplasms / Q000188:drug therapy / Q000556:secondary / Q000601:surgery; D008875:Middle Aged; D009367:Neoplasm Staging; D016896:Treatment Outcome; D000093542:Gemcitabine
chemical_list: D003841:Deoxycytidine; D002945:Cisplatin; D000093542:Gemcitabine