title: [A Case of Lymph Node Metastasis of Intrahepatic Bile Duct Cancer Successfully Treated Using Multidisciplinary Therapy].
abstract: We report a case of lymph node metastasis of intrahepatic bile duct cancer that was successfully treated using chemotherapy and radiation therapy.A man in his 70s underwent hepatic resection for intrahepatic bile duct cancer, and abdominal CT 1 year 8 months after surgery revealed lymph node swelling(25mm in diameter)along the common hepatic artery.He was diagnosed with lymph node metastasis and began to receive chemotherapy.We administered gemcitabine(GEM), cisplatin, and S-1 for 6 months, and GEM and S-1 for 1 year 4 further months as combination therapy.One year 10 months after the start of chemotherapy, the size of the lymph node decreased to 13 mm.However, as FDG uptake was seen on FDG-PET, radiation targeted to the lymph node was applied(50 Gy/25 Fr).After completion of radiation therapy, the lymph node has not regrown even in the absence of treatment, and the patient survives 6 years after the primary operation(4 years 4 months since the start of chemotherapy for recurrence).This case suggested that multidisciplinary therapy might be useful for lymph node metastasis of intrahepatic bile duct cancer.
authors.affiliation: Dept. of Surgery, National Hospital Organization Osaka National Hospital.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Miyamoto
authors.forename: Naoki
authors.initials: N
authors.lastname: Hama
authors.forename: Sakae
authors.initials: S
authors.lastname: Maeda
authors.forename: Mamoru
authors.initials: M
authors.lastname: Uemura
authors.forename: Kazuyoshi
authors.initials: K
authors.lastname: Yamamoto
authors.forename: Kazumasa
authors.initials: K
authors.lastname: Miyake
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Nishikawa
authors.forename: Michihiko
authors.initials: M
authors.lastname: Miyazaki
authors.forename: Masataka
authors.initials: M
authors.lastname: Ikeda
authors.forename: Motohiro
authors.initials: M
authors.lastname: Hirao
authors.forename: Mitsugu
authors.initials: M
authors.lastname: Sekimoto
authors.forename: Shoji
authors.initials: S
authors.lastname: Nakamori
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001650:Bile Duct Neoplasms / Q000473:pathology / Q000628:therapy*; D001653:Bile Ducts, Intrahepatic / Q000473:pathology* / Q000601:surgery; D003131:Combined Modality Therapy; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D004338:Drug Combinations; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D010094:Oxonic Acid / Q000008:administration & dosage; D012008:Recurrence; D005641:Tegafur / Q000008:administration & dosage; D016896:Treatment Outcome; D000093542:Gemcitabine
chemical_list: D004338:Drug Combinations; D003841:Deoxycytidine; C079198:S 1 (combination); D005641:Tegafur; D010094:Oxonic Acid; D000093542:Gemcitabine