Aoki Shuichi, Mizuma Masamichi, Oyauchi Motoki, Yoshida Hiroshi, Okada Ryo, Abe Tomoya, Sakata Naoaki, Nakagawa Kei, Hayashi Hiroki, Morikawa Takanori, Motoi Fuyuhiko, Naitoh Takeshi, Okada Yoshinori, Unno Michiaki
Dept. of Surgery, Tohoku University School of Medicine.
Gan To Kagaku Ryoho. 2015 Nov;42(12):1573-5.
We report of a patient with 3-year relapse-free survival after surgical resection for lung and liver metastases of distal cholangiocarcinoma (DCC). A quinquagenarianman was taken to a local hospital in October 2009 for yellow urine. He was diagnosed with DCC and was referred to our hospital for surgery. Pancreaticoduodenectomy was performed, and there was no residual tumor on histological examination. He did not receive any adjuvant therapy. One year 7 months after surgery, an isolated lung metastasis was identified on CT and was surgically removed. Six months after resection of the lung metastasis, a solitary liver metastasis was detected. Although systematic chemotherapy (gemcitabine plus S-1; 2 weeks treatment, 1 week drug free) was administered, the treatment was abandoned because of grade 3 (CTCAE v4.0) of skin disorders during the third course. Partial resection of the liver was performed in April 2012. Alternate-day treatment with S-1 was performed after resection of liver metastasis and is ongoing without adverse events. He has survived for more than 3 years without recurrence after liver resection. In this case of DCC metastasis, prognosis improved with surgical resection.
我们报告了一例远端胆管癌(DCC)肺和肝转移灶手术切除后无瘤生存3年的患者。一名50岁男性于2009年10月因尿液发黄被送往当地医院。他被诊断为DCC,并被转诊至我院接受手术。行胰十二指肠切除术,组织学检查未见残留肿瘤。他未接受任何辅助治疗。术后1年7个月,CT检查发现孤立性肺转移灶并手术切除。肺转移灶切除6个月后,发现孤立性肝转移。尽管给予了系统化疗(吉西他滨加S-1;2周治疗,1周停药),但在第三个疗程时因出现3级(CTCAE v4.0)皮肤病变而放弃治疗。2012年4月行肝部分切除术。肝转移灶切除后采用S-1隔日治疗,目前仍在进行且无不良事件发生。肝切除术后他已存活3年多无复发。在该例DCC转移患者中,手术切除改善了预后。