ABSTRACT
We report a case of postoperative dissemination of intrahepatic biliary tract cancer subsequently treated with intraperitoneal chemotherapy combined with systemic chemotherapy. A 61-year-old-woman who underwent hepatic resection 18 months before was admitted for abdominal distension. CT scan revealed a recurrent tumor in her transverse mesocolon. We tried tumor resection but peritoneal dissemination was recognized, and intraperitoneal chemotherapy was started followed by systemic hemotherapy. For 34 months after the diagnosis of postoperative peritoneal dissemination, the patient has not suffered from abdominal distension and stenosis of the gastrointestinal tract. The CA19-9 level remained low for over 30 months. Intraperitoneal chemotherapy followed by systemic chemotherapy in this case seemed to delay the progression of disseminated tumor and to preserve the quality of life of the patient. The present case shows the effectiveness of intraperitoneal chemotherapy with or followed by systemic chemotherapy for patients who had peritoneal disseminations.
Subject(s)
Antineoplastic Agents/administration & dosage , Bile Duct Neoplasms/pathology , Bile Ducts, Intrahepatic , Neoplasm Seeding , Peritoneal Neoplasms/drug therapy , Peritoneal Neoplasms/pathology , Bile Duct Neoplasms/surgery , CA-19-9 Antigen/analysis , Female , Hepatectomy , Humans , Mesocolon , Middle Aged , Peritoneal CavityABSTRACT
We reported a case of non-resectable intrahepatic biliary tract cancer, treated with Gemcitabine and oral anticancer drugs. A 45-year-old man was admitted to the hospital due to abdominal distension and fatigue. CT scan revealed intrahepatic biliary tract cancer in the left lobe, which had metastasized to both lobes. Based on the diagnosis of non-resectable intrahepatic biliary tract cancer, systemic chemotherapy using gemcitabine (GEM) was employed. One course of the treatment consisted of 4 weeks. GEM 1,000 mg was administered once a week for 3 weeks followed by a week of no treatment. At the same time, the oral anti-cancer drug (5'-DFUR 600 mg/day) was administered every day. After 4 courses of chemotherapy, both the primary tumor and the hepatic metastasis were diminished, and the serum level of CA19-9 was reduced to the normal value. Relief from the abdominal distension allowed the patient to return to work. The chemotherapy was continued by outpatient-clinic treatment, preserving the quality of life for 13 months. The present case shows that gemcitabine/5'-DFUR combination is well supported in advanced unresectable biliary tract cancer.
