1. [A Case of Intrahepatic Cholangiocarcinoma and Early Postoperative Recurrences Using Comprehensive Genome Profiling to Implement Effective Treatment].
- Author
-
Yotsumoto T, Ando Y, Sakamoto A, Feng D, Nagao M, Matsukawa H, Nishiura B, Kondo A, Suto H, Asano E, Okuyama H, Kishino T, Oshima M, Kumamoto K, Tsuji A, and Okano K
- Subjects
- Humans, Male, Middle Aged, Hepatectomy, Cholangiocarcinoma surgery, Cholangiocarcinoma genetics, Cholangiocarcinoma drug therapy, Bile Duct Neoplasms surgery, Bile Duct Neoplasms genetics, Bile Duct Neoplasms drug therapy, Recurrence, Antineoplastic Combined Chemotherapy Protocols therapeutic use
- Abstract
Subsequent to a medical examination, a 61-year-old male was referred to our hospital with jaundice. He was diagnosed with intrahepatic cholangiocarcinoma involving the hepatic hilum and was referred to our department to undergo a left trisectionectomy of the liver, extrahepatic bile duct resection, and regional lymphadenectomy. He was discharged on postoperative day 39 without liver failure. Two months postoperatively, positron-emission tomography/computed tomography(PET/ CT)indicated recurrences in the bone, and paraaortic lymph node. Gemcitabine and cisplatin combination first-line therapy was administered. Disease progression occurred after 4 courses of therapy. Gene panel testing was performed and the patient was switched to pembrolizumab owing to high microsatellite instability. After 2 courses of pembrolizumab, notable shrinkage of the paraaortic lymph node recurrence was confirmed on computed tomography as well as a partial response. PET-CT revealed disappearance of abnormal accumulation in all lesions at 20 months postoperatively. This has been sustained for 24 months following surgery without remarkable immune-related side-effects.
- Published
- 2024