Analysis of the Clinical Course in a Population of Patients with Biliary Tract Cancer Diagnosed as Unresectable After Portal Vein Embolization: A Case Series

DOI Web Site 参考文献20件
  • IMAMURA HAJIME
    Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences
  • ADACHI TOMOHIKO
    Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences
  • MATSUSHIMA HAJIME
    Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences
  • ISHIMARU HIDEKI
    Department of Radiology, Nagasaki University Hospital
  • FUKUMOTO MASAYUKI
    Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences
  • YOSHINO KYOHEI
    Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences
  • MATSUGUMA KUNIHIRO
    Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences
  • MATSUMOTO RYO
    Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences
  • HARA TAKANOBU
    Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences
  • SOYAMA AKIHIKO
    Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences
  • HIDAKA MASAAKI
    Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences
  • EGUCHI SUSUMU
    Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences

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<p>Summary: Portal vein embolization (PVE) is recommended as a preoperative procedure for patients with biliary tract cancer scheduled to undergo hepatic resection of more than 50%–60% of the liver. However, details and/or information regarding the follow-up of unresectable cases are often lacking, and the clinical course of unresectable cases is not well analyzed and reported. This study aimed to clarify the clinical prognosis of patients with unresectable biliary tract cancer after PVE. We retrospectively analyzed the clinical backgrounds of patients with biliary tract cancer who underwent PVE without subsequent resection between January 2011 and October 2022. Of the 21 patients with biliary tract cancer who underwent PVE during the study period, eight (38%) cases were unsuitable for resection after PVE for the following reasons: intraoperatively detected dissemination (n=2), para-aortic lymph node metastasis (n=1), liver metastasis (n=1), decreased liver function (n=2), development of liver metastasis while waiting (n=1), and insufficient residual liver volume (n=1). All patients received subsequent chemotherapy, including gemcitabine plus S-1 therapy in three cases, gemcitabine plus cisplatin plus S-1 in three cases, and gemcitabine plus cisplatin or S-1+cisplatin in one case each. As there is currently no curative treatment for biliary tract cancer other than surgery, multidisciplinary management and treatment of patient factors, including tumor factors and liver function, are essential to reducing the number of unresectable cases after PVE.</p>

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