[Two cases of curatively resected intrahepatic cholangiocellular carcinomas through effective response to neoadjuvant
Naoko Kamo1, Akira Mori, Takashi Nitta
1Dept. of Hepato-Biliary Pancreatic Surgery and Transplantation, Kyoto University Hospital.
Abstract:
Case 1:A 61-year-old man was diagnosed as cholangiocellular carcinoma with para-aortic lymph node metastasis (T4N1M0, cStage IV B). After 9 courses of chemotherapy using gemcitabine(GEM), CT scan showed that primary lesion and metastatic lymph nodes were reduced in size, and FDG-PET showed no FDG accumulation in the lymph nodes. The patient decided to continue additional chemotherapy with GEM and hyperthermia. Despite the chemo-hyperthermia, the primary tumor re-grew. He then underwent right trisegmentectomy, lymph node dissection, and reconstruction of the biliary tract. The final stage was T3N0M0, fStage III . Case 2: A 65-year-old man was diagnosed as cholangiocellular carcinoma with massive arterial invasion(T3N1M0, cStage IV B). After 3 courses of chemotherapy for GEM plus S-1, a CT scan revealed that the main tumor and metastatic lymph nodes were reduced in size, and he underwent extended left lobectomy of liver, lymph node dissection, and reconstruction of the biliary tract. The final stage was T1N0M0, fStage I . These cases indicated that neoadjuvant chemotherapy by gemcitabine was indeed promising for some cases of biliary tract cancer.
