A resected case of advanced hilar cholangiocarcinoma through effective responsive to neoadjuvant chemotherapy

Abstract

We report a case of curative resection of advanced hilar cholangiocarcinoma that responsed well to neoadjuvant chemotherapy; combined S-1/gemcitabine (GEM) therapy. A 67-year-old man was admitted to the local hospital because of upper abdominal discomfort and dark urine. PTBD was performed, and he was referred to our hospital with diagnosis as Bismuth type IV hilar cholangiocarcinoma. The hepatic hilar tumor extended around the left portal vein and metastatic No.8 lymph node was detected by abdominal CT. Serum DUPAN-2 level was elevated to more than 1600 U/ml. He was started on combined chemotherapy with S-1 80 mg/day on day 1-21 and GEM 1000 mg on day 8, 22. After completion of two course, serum DUPAN-2 level decreased to 450 U/ml, the abnormal accumulation on FDG-PET disappeared. A left hepatectomy with combined resection of caudate lobe was performed to obtain a possible safety margin. These treatment resulted in complete normalization of the serum DUPAN-2 level.