title: [Long Term Survival in a Case of Hilar Cholangiocarcinoma Treated with Chemotherapy and Surgery].
abstract: A 67-year-old man with elevated hepatobiliary enzymes was referred to our hospital for further examination. Computed tomography indicated hilar cholangiocarcinoma of Bismuth type Ⅳ and revealed invasion of the right hepatic artery and the left portal vein. We diagnosed locally advanced unresectable hilar cholangiocarcinoma, and performed 5 courses of chemotherapy with gemcitabine plus S-1. After chemotherapy, the tumor was significantly reduced in size and vascular invasions were alleviated, so we decided to perform surgical resection. An extended left hepatectomy with caudate lobe and extrahepatic bile duct resection was performed. Although the intraoperative pathological examination was positive for cancer at the hepatic margins, we did not perform further bile duct resection because of the difficulty. After the surgery, we administered adjuvant chemotherapy with gemcitabine for 5 courses. Another 8 courses of gemcitabine plus S-1 therapy were given because of elevation of CA19-9. The tumor marker levels normalized, and the patient is still alive without findings of recurrence 4 years after the first treatment. Multidisciplinary treatment with chemotherapy and surgery may suggest the possibility of increasing long term survival even for patients with locally advanced unresectable cholangiocarcinoma.
authors.affiliation: Dept. of Surgery, Tokyo Metropolitan Bokutoh Hospital.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kanomata
authors.forename: Yasuji
authors.initials: Y
authors.lastname: Seyama
authors.forename: Keigo
authors.initials: K
authors.lastname: Tani
authors.forename: Toru
authors.initials: T
authors.lastname: Tanizawa
authors.forename: Masahiro
authors.initials: M
authors.lastname: Warabi
authors.forename: Minekazu
authors.initials: M
authors.lastname: Murayama
authors.forename: Toru
authors.initials: T
authors.lastname: Asano
authors.forename: Masamichi
authors.initials: M
authors.lastname: Takahashi
authors.forename: Yujiro
authors.initials: Y
authors.lastname: Matsuoka
authors.forename: Yukio
authors.initials: Y
authors.lastname: Miyamoto
authors.forename: Nobutaka
authors.initials: N
authors.lastname: Umekita
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001650:Bile Duct Neoplasms / Q000188:drug therapy* / Q000601:surgery; D018281:Cholangiocarcinoma / Q000188:drug therapy* / Q000601:surgery; D003131:Combined Modality Therapy; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D004338:Drug Combinations; D006498:Hepatectomy; D006801:Humans; D008297:Male; D010094:Oxonic Acid / Q000008:administration & dosage; D010180:Pancreatectomy; D005641:Tegafur / Q000008:administration & dosage; D013997:Time Factors; D016896:Treatment Outcome; D000093542:Gemcitabine
chemical_list: D000970:Antineoplastic Agents; D004338:Drug Combinations; D003841:Deoxycytidine; C079198:S 1 (combination); D005641:Tegafur; D010094:Oxonic Acid; D000093542:Gemcitabine