Department of Surgery, Saga University Faculty of Medicine, Nabeshima 5-1-1, Saga, 849-8501, Japan.
World J Surg Oncol. 2014 Nov 4;12:326. doi: 10.1186/1477-7819-12-326.
A 62-year-old woman diagnosed with gallbladder cancer exhibiting broad liver invasion and metastasis to Couinaud's hepatic segments 4 and 8 (S4 and S8) consulted her regular doctor. Owing to the presence of liver metastases, she received treatment with gemcitabine plus S-1. After four cycles of chemotherapy, the size of the main lesion dramatically decreased and the two liver metastases disappeared. After six cycles of chemotherapy, the patient was referred to our hospital for surgical treatment. Upon admission, there was no evidence of any distant metastasis, based on a detailed radiological examination. Therefore, we performed cholecystectomy and central bisegmentectomy of the liver after obtaining the patient's informed consent. Pathological examination demonstrated viable cancer cells with granuloma formation and calcification in the gallbladder, as well as regenerative changes without viable cancer cells in S4 and S8 of the liver. Gemcitabine plus S-1 was again administered as postoperative adjuvant chemotherapy. One and a half years after the surgery, there were no signs of recurrence. In patients selected according to their response to chemotherapy, surgical treatment might therefore be effective against gallbladder cancer with metastasis.
一位 62 岁女性被诊断患有胆囊癌，广泛侵犯肝脏并转移至 Couinaud 肝段 S4 和 S8（S4 和 S8），她咨询了她的主治医生。由于存在肝转移，她接受了吉西他滨加 S-1 的治疗。经过四个周期的化疗，主要病变显著缩小，两个肝转移灶消失。六个周期的化疗后，患者被转介到我们医院接受手术治疗。入院时，根据详细的影像学检查，没有任何远处转移的证据。因此，在获得患者知情同意后，我们进行了胆囊切除术和肝中叶切除术。病理检查显示胆囊内有活癌细胞和肉芽肿形成及钙化，S4 和 S8 肝内有再生改变而无活癌细胞。术后再次给予吉西他滨加 S-1 辅助化疗。手术后 1 年半，无复发迹象。对于根据化疗反应选择的患者，手术治疗可能对转移性胆囊癌有效。
