A Long-Term Survivor of Advanced Gallbladder Carcinoma Accompanied by Liver Cirrhosis Received Repeated Low-Dose Gemcitabine Administration as Adjuvant Chemotherapy Following Non-Curative Resection

Kazuhiko Fukumoto, Shohachi Suzuki, Yoshifumi Morita, Kosuke Oishi, Atsushi Suzuki, Keisuke Inaba, Takanori Sakaguchi, Yasuo Takehara¹⁾, Satoshi Baba²⁾ and Hiroyuki Konno

Second Department of Surgery, Department of Radiology¹⁾ and Department of Pathology²⁾, Hamamatsu University School of Medicine

A 55-year-old man referred for epigastralgia under a diagnosis of advanced gallbladder carcinoma complicated by liver cirrhosis related to HBV infection was found in abdominal computed tomography to have cancer invasion to the liver and omentum. We conducted partial hepatectomy and removal of the extrahepatic bile duct with biliary tract reconstruction. Lymphadenectomy was conducted on the cystic duct and pericholedochal nodes due to the presence of a small amount of ascites associated with liver cirrhosis. The histological diagnosis was well-to-moderately differentiated adenocarcinoma of the gallbladder with cancer invasion to the liver and omentum (fstage IVa: pT4, pN0, pM (-) ), and tissue at the surgical margin of the liver was positive for cancer. Based on these findings, the surgical outcome was judged to be non curative resection. Low-dose gemcitabine (GEM: 400 mg/body) was administered repeatedly in postoperative adjuvant chemotherapy for a total dosage of 48.8 g. The patient is doing well without disease recurrence 5years after surgery. Low-dose GEM therapy is thus a promising for adjuvant chemotherapy for biliary tract carcinoma.

Key words
gallbladder cancer, low-dose Gemcitabine, adjuvant chemotherapy

Reprint requests
Kazuhiko Fukumoto Second Department of Surgery, Hamamatsu University School of Medicine
1-20-1 Handayama, Hamamatsu, 431-3192 JAPAN

Accepted
January 30, 2008

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