Adjuvant surgery for advanced extrahepatic cholangiocarcinoma
Yukio Oshiro1, Kazuhiro Takahashi, Ryoko Sasaki
1Yukio Oshiro, Kazuhiro Takahashi, Ryoko Sasaki, Tadashi Kondo, Nobuhiro Ohkohchi, Department of Surgery, Division of Gastroenterological and Hepatobiliary Surgery, and Organ Transplantation, University of Tsukuba, Tsukuba 305-8575, Japan.
World Journal of Gastroenterology
|November 5, 2013
Summary
Advanced cholangiocarcinoma can become resectable after chemotherapy. Adjuvant surgery following gemcitabine chemotherapy offers a potentially curative option for select Stage IV cholangiocarcinoma patients.
Area of Science:
- Oncology
- Surgical Oncology
- Gastroenterology
Background:
- Stage IV cholangiocarcinoma is generally unresectable, with treatment limited to systemic chemotherapy.
- Novel chemotherapy regimens are improving resectability rates for initially unresectable cholangiocarcinoma.
- This case highlights the potential benefit of adjuvant surgery in advanced cholangiocarcinoma.
Observation:
- A 72-year-old male with Stage IV distal cholangiocarcinoma and liver metastases presented with jaundice.
- The patient received 18 courses of gemcitabine chemotherapy, leading to complete resolution of liver metastases.
- Following chemotherapy, the patient underwent successful subtotal stomach-preserving pancreaticoduodenectomy and lymph node dissection.
Findings:
- The pathological stage post-surgery was pT2N0M0, Stage IB.
- The patient received 6 cycles of adjuvant gemcitabine chemotherapy.
- The patient remains disease-free 6 years and 9 months post-diagnosis.
Implications:
- Adjuvant surgery may be a viable option for select patients with initially unresectable cholangiocarcinoma that becomes resectable after neoadjuvant chemotherapy.
- This approach can lead to long-term survival in advanced cholangiocarcinoma.
- Further research into neoadjuvant chemotherapy followed by surgery for advanced cholangiocarcinoma is warranted.
