Ogura Nozomu, Hoshino Mai, Hayashi Tomoyasu, Odaira Masanori, Harada Hirohisa, Hirose Shigemichi, Funakoshi Shinsuke
Division of Medical Oncology, Tokyo Saiseikai Central Hospital.
Gan To Kagaku Ryoho. 2022 Dec;49(13):1665-1667.
A 61-year-old male suffered from intrahepatic cholangiocarcinoma in S7 lesion(90 mm diameter), diagnosed by hepatic tumor biopsy. As PET-CT showed para-aortic lymph node metastasis(cT3N1M1, cStage ⅣB), and judged to be unresectable, he received neoadjuvant chemotherapy of gemcitabine, cisplatin, and S-1(GCS). After 7 courses of GCS, CT showed partial response of the primary tumor and PET-CT showed decreased accumulation of FDG at para-aortic lymph node. Resectability was reexamined and the patient underwent S7 extended subsegmentectomy as conversion surgery. Furthermore, after the surgery, he received adjuvant chemotherapy of S-1 for 6 months, and he remained relapse-free for the next 2 years. Cholangiocarcinoma is one of the most poorly prognosed type cancer. Conversion surgery for unresectable intrahepatic cholangiocarcinoma is frequently reported, but there are still few reports of GCS as neoadjuvant chemotherapy. Here, we report a case of unresectable intrahepatic cholangiocarcinoma that was successfully treated with GCS and underwent conversion surgery.
一名61岁男性，经肝脏肿瘤活检确诊为S7段肝内胆管癌（直径90mm）。正电子发射断层扫描-计算机断层扫描（PET-CT）显示腹主动脉旁淋巴结转移（cT3N1M1，c期ⅣB），判断为不可切除，遂接受吉西他滨、顺铂和替吉奥（GCS）新辅助化疗。7个疗程的GCS治疗后，CT显示原发肿瘤部分缓解，PET-CT显示腹主动脉旁淋巴结的氟代脱氧葡萄糖（FDG）摄取减少。重新评估可切除性后，患者接受了S7段扩大亚段切除术作为转化手术。此外，术后患者接受了6个月的替吉奥辅助化疗，随后2年无复发。胆管癌是预后最差的癌症类型之一。不可切除肝内胆管癌的转化手术屡有报道，但关于GCS作为新辅助化疗的报道仍较少。在此，我们报告1例不可切除肝内胆管癌经GCS成功治疗并接受转化手术的病例。
