Abstract
Background : The prognosis of patients with locally advanced or initially unresectable (so-called “initially resection-ineligible”) biliary tract carcinoma is poor, and the long-term survival can usually not be expected in unresected cases. Some reports revealed that salvage surgery following chemoradiation therapy might offer prolonged survival, however, the prognostic impact of salvage surgery is still under debate.
Methods : The patient background, preoperative therapy, perioperative results and R-status were evaluated in 3 cases of locally advanced or initially resection-ineligible biliary tract carcinoma treated by salvage surgeries between January 2011 and December 2012.
Results : The treatment protocol included combined gemcitabine plus CDDP or S1 therapy and irradiation (50.4 Gy) with daily S1 administration. The duration of the chemoradiation therapy ranged from 4 to 9 months. The treatment response was classified as stable disease or partial response (SD/PR) in all three cases, therefore, salvage surgery was scheduled. Histopathological examination revealed downstaging of the disease with R0 in all the cases.
Conclusions : Salvage surgery following definite chemoradiation therapy might offer improvement of the pathological outcome in patients with locally advanced or initially resection-ineligible biliary tract carcinoma.
