[胆囊癌复发肝转移患者成功接受 GC+Durvalumab 化疗后行根治性肝切除术的病例].

Q4 Medicine
Taiichiro Miyake, Takeshi Urade, Shohei Komatsu, Hidetoshi Gon, Kenji Fukushima, Shinichi So, Keisuke Arai, Sadaki Asari, Hiroaki Yanagimoto, Hirochika Toyama, Masahiro Kido, Takumi Fukumoto
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引用次数: 0

摘要

一名49岁的男子于2021年因晚期胆囊癌接受了开腹胆囊切除术。术后3个月,患者再次接受切除术,术后未发现恶性病变,但术后12个月,对比增强CT和MRI显示肝脏第8段出现新的肿块病变,患者被诊断为胆囊癌术后肝转移复发。转诊至我院后,他接受了1个疗程的吉西他滨+顺铂(GC)治疗和8个疗程的吉西他滨+顺铂+达伐单抗(GCD)治疗。对比增强 CT 和 MRI 显示转移灶已缩小,PET 扫描显示无 FDG 累积。化疗结束两个月后,没有发现转移灶扩大和新的转移灶(包括远处转移灶),患者被转到我科。由于预计会进行根治性切除,因此对患者进行了腹腔镜下第 8 段肝部分切除术。病理诊断显示无残余肿瘤。如果全身化疗能很好地控制转移灶,胆道癌肝转移的肝切除术不失为一种治疗选择。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[A Case of Radical Hepatectomy in a Patient with Recurrent Liver Metastasis of Gallbladder Cancer after Successful Chemotherapy with GC+Durvalumab].

A 49-year-old man underwent an open cholecystectomy for advanced gallbladder cancer in 2021. Three months after surgery, the patient underwent an additional resection, which showed no malignant findings, but 12 months after surgery, contrast-enhanced CT and MRI showed a new mass lesion in segment 8 of the liver, and the patient was diagnosed with postoperative hepatic metastatic recurrence of gallbladder cancer. After referral to our institution, he received 1 course of gemcitabine+cisplatin(GC)therapy and 8 courses of gemcitabine+cisplatin+durvalumab(GCD)therapy. Contrast- enhanced CT and MRI showed that the metastases had shrunk, and PET scan showed no FDG accumulation. Two months after completion of chemotherapy, there was no evidence of metastatic enlargement and new metastasis including distant metastasis, and the patient was referred to our department. Since curative resection was expected, a laparoscopic partial hepatectomy of segment 8 of the liver was performed. Pathological diagnosis revealed no residual tumor. If the metastases could be well controlled by systemic chemotherapy, hepatectomy for hepatic metastases of biliary tract cancer could be a treatment option.

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