[A Three-Year Survival Case of Extrahepatic Cholangiocarcinoma Treated with Palliative Bile Duct Resection and S-1...

We report a 3-year survival case of cholangiocarcinoma treated with S-1 monotherapy despite positive margins after palliative bile duct resection. A 66 year-old man visited our hospital for jaundice. Because a smooth round defect was observed in the middle bile duct on ERCP, an impacted stone was suspected. Bile duct incision was performed, but the suspected stone was a tumor that was pathologically diagnosed as cholangiocarcinoma. Although pancreaticoduodenectomy was recommended, the patient decided to undergo palliative bile duct resection. Postoperative pathological examination showed moderately tubular adenocarcinoma with lymph node metastasis. The surgical margins of the hepatic side, duodenal side, and exfoliated surface were all positive. Subsequently, the patient chose to undergo S-1 monotherapy for maintaining his lifestyle. S-1 was orally administered at 100mg/day for 4 weeks, followed by 2 weeks of rest. He has continued S-1 monotherapy and survived for 3 years without evidence of recurrence.