title: Histological complete response in a patient with advanced biliary tract cancer treated by gemcitabine/cisplatin/S-1 combination chemotherapy: A case report.
abstract: A 68-year-old woman was referred to our hospital with increased levels of biliary enzymes. On imaging, the patient was diagnosed with unresectable intrahepatic biliary tract cancer (BTC) with invasion of the portal vein and para-aortic lymph node metastasis (cT3N1M1, cStage IVb) and underwent endoscopic biliary drainage for the biliary stricture prior to therapy. The patient was subsequently enrolled in a phase III randomized trial (UMIN000014371/NCT02182778) and randomly assigned to receive gemcitabine/cisplatin/S-1 (GCS) combination therapy intravenously at doses of 1,000 or 25 mg/m2on day 1 and orally twice daily at a dose of 80 mg/m2on days 1-7 every 2 weeks. After 12 cycles of scheduled therapy without uncontrollable adverse effects, the patient achieved a good partial response with chemotherapy. Computed tomography (CT) revealed a marked reduction of the primary and metastatic lesions. In addition,18F-fluorodeoxyglucose-positron emission tomography/CT revealed diminishing abnormal uptake and no macroscopic evidence of factors adversely affecting tumor resectability. Therefore, the patient underwent extended right hepatic lobectomy, lymph node dissection and left hepaticojejunostomy. Finally, histological examination of the resected tissues revealed no residual cancer cells, suggesting a pathologically complete response. We herein present the case of a patient with intrahepatic BTC who achieved a pathologically complete response following combination chemotherapy with GCS.
authors.affiliation: Department of Gastroenterology, Toyonaka Municipal Hospital, Toyonaka, Osaka 560-8565, Japan.
authors.forename: Tokuhiro
authors.initials: T
authors.lastname: Matsubara
authors.affiliation: Department of Gastroenterology, Toyonaka Municipal Hospital, Toyonaka, Osaka 560-8565, Japan.
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Nishida
authors.affiliation: Department of Surgery, Toyonaka Municipal Hospital, Toyonaka, Osaka 560-8565, Japan.
authors.forename: Yoshito
authors.initials: Y
authors.lastname: Tomimaru
authors.affiliation: Department of Gastroenterology, Toyonaka Municipal Hospital, Toyonaka, Osaka 560-8565, Japan.
authors.forename: Masashi
authors.initials: M
authors.lastname: Yamamoto
authors.affiliation: Department of Gastroenterology, Toyonaka Municipal Hospital, Toyonaka, Osaka 560-8565, Japan.
authors.forename: Shiro
authors.initials: S
authors.lastname: Hayashi
authors.affiliation: Department of Gastroenterology, Toyonaka Municipal Hospital, Toyonaka, Osaka 560-8565, Japan.
authors.forename: Sachiko
authors.initials: S
authors.lastname: Nakajima
authors.affiliation: Department of Gastroenterology, Toyonaka Municipal Hospital, Toyonaka, Osaka 560-8565, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Fukui
authors.affiliation: Department of Surgery, Toyonaka Municipal Hospital, Toyonaka, Osaka 560-8565, Japan.
authors.forename: Keizo
authors.initials: K
authors.lastname: Dono
authors.affiliation: Department of Pathology, Toyonaka Municipal Hospital, Toyonaka, Osaka 560-8565, Japan.
authors.forename: Shiro
authors.initials: S
authors.lastname: Adachi
authors.affiliation: Department of Hepatobiliary and Pancreatic Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka 537-0025, Japan.
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Ioka
authors.affiliation: Department of Clinical Oncology and Pharmacogenomics, Kyoto University Hospital, Kyoto 606-8507, Japan.
authors.forename: Masashi
authors.initials: M
authors.lastname: Kanai
authors.affiliation: Department of Gastroenterology, Toyonaka Municipal Hospital, Toyonaka, Osaka 560-8565, Japan.
authors.forename: Masami
authors.initials: M
authors.lastname: Inada
keywords: S-1; biliary tract cancer; cholangiocarcinoma; cisplatin; gemcitabine