A Case of Recurrent Gallbladder Cancer with Complete Response to Gemcitabine plus S-1 Combination Chemotherapy

Abstract

Prognosis of biliary tract cancer has generally been poor, and effective chemotherapy has not yet been established. A 64 year-old woman was admitted to our hospital for indications of gallbladder wall thickness. The diagnosis on computed tomography and ultrasonography was gallbladder cancer with liver metastasis in the inferior anterior segment. A cholecystectomy with partial hepatectomy was performed, and lymph nodes associated with the hepatoduodenal ligament, periampullary lesion, and common hepatic artery were dissected.Chemotherapy with gemcitabine after resection biweekly was administered. After 4 months, liver metastases in the anterior segment was recognized. A right hepatic lobectomy was performed. After another 4 months, lymph node metastases of posterior lesions of the pancreas head, and caudate lobe metastasis were found. We initiated combination chemotherapy using gemcitabine plus tegafur・gimeracil・oteracil potassium (S-1). Complete response to chemotherapy was confirmed after 12 cycles. CA19-9 values reverted to normal levels. No major events of toxicity were seen. After 15 months, complete response had been maintained. Biweekly gemcitabine plus S-1 combination chemotherapy was effective and well tolerated.