[A case of advanced cholangiocellular carcinoma treated successfully by percutaneous isolated liver perfusion with...

Herein reported is a case with unresectable intrahepatic cholangiocellular carcinoma (CCC) treated successfully with high-dose cisplatin infusion under hepatic venous isolation and charcoal hemoperfusion (HVI.CHP). The patient was a 43-year-old woman, who was investigated for liver dysfunction and subsequently referred to our institution with a diagnosis of unresectable intrahepatic CCC. We gave this patient a total of 2 treatments of percutaneous isolated liver perfusion with HVI.CHP (a total dose of cisplatin, 400 mg and adriamycin 30 mg). Although she had a slight elevation of serum GOT levels, leukopenia and renal dysfunction did not occur throughout the posttreatment course. The level of DUPAN-2 after the first treatment showed a marked reduction to 910 U/ml, from a pretreatment level of 2,700 U/ml. Abdominal CT scan also demonstrated a remarkable regression of liver tumors (PR: volume reduction, 76%). In conclusion, in percutaneous isolated liver perfusion using HVI.CHP, we have safely accomplished a dose intensification of intraarterial cisplatin. The treatment resulted in a marked tumor regression. Therefore, we consider that this method offers an effective therapeutic option for unresectable CCC.