二度の腫瘍切除を含む集学的治療で，長期生存が得られた肝内胆管癌の１例

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Intrahepatic cholangiocarcinoma(IHC) has a poor prognosis, and no standard treatments for IHC recurrence after the first hepatectomy has been established to date. Here, we report a case of a patient with recurrent IHC who achieved long-term survival due to multidisciplinary therapy after the first hepatectomy. A 74-years-old woman was initially diagnosed with stage 3 IHC. A huge mass was detected in the left lobe of her liver, and extended left hepatectomy was performed.Thereafter, she underwent adjuvant chemotherapy with gemcitabine (GEM) for 1 year.However,the lesion recurred in the hilar lymph nodes 23 months after the first hepatectomy.The involved lymph nodes were resected and adjuvant chemotherapy was administered.A second recurrence developed in the caudate lobe of the residual liver 18 months after the lymph nodes resection.Chemoradiotherapy(CRT) with GEM was administered, followed by chemotherapy. As of now, 5years and 7 months since the completion CRT,no recurrence has occured.Thus,we propose that continuous multidisciplinary therapy is necessary to increase the possibility of long-term survival in patients with recurrent IHC.Ryukyu Med.J.,31(1,2)51～56,2012
琉球医学会の論文