3度の手術を含む集学的治療によりR0切除しえたStage IVB偶発胆囊癌の1例
症例は73歳の女性で，腹腔鏡下胆囊摘出術後のpT2（SS）偶発胆囊癌のため肝床部切除術が追加された．しかし，術中肝切離面には多数の微少結節を認め，術後病理検査にてそれらは全て転移巣と判明し，胆囊癌pT3a（肝臓），pN1，M1（肝臓），pStage IVBと診断された．術後gemcitabine+S-1療法（以下，GS療法と略記）を開始したが，開始時より6か月間一貫して肝転移病変を認めなかった．術中所見からは，肝切離面に転移巣が遺残しており，確実なR0切除達成のため三期的手術として肝中央下区域切除術を追加した．切除標本には2か所の微少肝転移を認めたが，各々90%および50%の壊死を伴っていた．...
Saved in:
| Published in | 日本消化器外科学会雑誌 Vol. 52; no. 3; pp. 166 - 175 |
|---|---|
| Main Authors | , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
一般社団法人 日本消化器外科学会
01.03.2019
|
| Subjects | |
| Online Access | Get full text |
| ISSN | 0386-9768 1348-9372 |
| DOI | 10.5833/jjgs.2018.0077 |
Cover
| Abstract | 症例は73歳の女性で，腹腔鏡下胆囊摘出術後のpT2（SS）偶発胆囊癌のため肝床部切除術が追加された．しかし，術中肝切離面には多数の微少結節を認め，術後病理検査にてそれらは全て転移巣と判明し，胆囊癌pT3a（肝臓），pN1，M1（肝臓），pStage IVBと診断された．術後gemcitabine+S-1療法（以下，GS療法と略記）を開始したが，開始時より6か月間一貫して肝転移病変を認めなかった．術中所見からは，肝切離面に転移巣が遺残しており，確実なR0切除達成のため三期的手術として肝中央下区域切除術を追加した．切除標本には2か所の微少肝転移を認めたが，各々90%および50%の壊死を伴っていた．術後は再度GS療法を6か月間施行し，現在初回治療開始後2年3か月で無再発生存中である．計3度の手術を要したが，術前後の化学療法を含めた集学的治療によりR0切除を達成しており，長期生存の可能性も示唆された． |
|---|---|
| AbstractList | 症例は73歳の女性で，腹腔鏡下胆囊摘出術後のpT2（SS）偶発胆囊癌のため肝床部切除術が追加された．しかし，術中肝切離面には多数の微少結節を認め，術後病理検査にてそれらは全て転移巣と判明し，胆囊癌pT3a（肝臓），pN1，M1（肝臓），pStage IVBと診断された．術後gemcitabine+S-1療法（以下，GS療法と略記）を開始したが，開始時より6か月間一貫して肝転移病変を認めなかった．術中所見からは，肝切離面に転移巣が遺残しており，確実なR0切除達成のため三期的手術として肝中央下区域切除術を追加した．切除標本には2か所の微少肝転移を認めたが，各々90%および50%の壊死を伴っていた．術後は再度GS療法を6か月間施行し，現在初回治療開始後2年3か月で無再発生存中である．計3度の手術を要したが，術前後の化学療法を含めた集学的治療によりR0切除を達成しており，長期生存の可能性も示唆された． |
| Author | 首藤, 毅 井上, 雅史 田代, 裕尊 瀬尾, 信吾 |
| Author_xml | – sequence: 1 fullname: 井上, 雅史 organization: 独立行政法人国立病院機構呉医療センター・中国がんセンター外科 – sequence: 1 fullname: 田代, 裕尊 organization: 独立行政法人国立病院機構呉医療センター・中国がんセンター外科 – sequence: 1 fullname: 瀬尾, 信吾 organization: 広島大学大学院医歯薬保健学研究科応用生命科学部門外科学 – sequence: 1 fullname: 首藤, 毅 organization: 独立行政法人国立病院機構呉医療センター・中国がんセンター外科 |
| BookMark | eNo9kD1Lw0AYxw9RsNauzn6B1Lvc5e4yan0rFAQtjoa7NKkNtUrSxc1EqbV1EB0kdhBBuogODg4V_DJn-vItbFBcnofn_4cfD78FMNs4bjgALCGYNzjGK55XDfI6RDwPIWMzIIMw4ZqJmT4LMhBzqpmM8nmQC4KahNDgbHqjDDjAyaCvwrfhVXf8dKei2-TmRUVnk14ree2PHi6G75-jOFLhNGyrqLMLk_blJH5W4b0K2yp83GuKqrNc3F9Lwo9RPBift5JeZxRfT5Ho-6u7COZcUQ-c3N_OgvLmRrmwrZV2toqF1ZLm6ZALDWNu2kRI3eGES-YSE0GCpITIoaYjTRcSl-qcYkiYoNSQpEINW3AmZEVUBM6C9V-sF6T_WCd-7Uj4p5bwmzW77lipHcvQLZyO1JKVWvqv7UPhW57AP9HNfdk |
| ContentType | Journal Article |
| Copyright | 2019 一般社団法人 日本消化器外科学会 |
| Copyright_xml | – notice: 2019 一般社団法人 日本消化器外科学会 |
| DOI | 10.5833/jjgs.2018.0077 |
| DatabaseTitleList | |
| DeliveryMethod | fulltext_linktorsrc |
| EISSN | 1348-9372 |
| EndPage | 175 |
| ExternalDocumentID | article_jjgs_52_3_52_2018_0077_article_char_ja |
| GroupedDBID | 2WC ALMA_UNASSIGNED_HOLDINGS EBS EJD JSF KQ8 OK1 RJT |
| ID | FETCH-LOGICAL-j208a-3389c4ab2e848b7f491041bb01e69eb9f04f62863047a665b4d65ca87abdada3 |
| ISSN | 0386-9768 |
| IngestDate | Wed Sep 03 06:23:50 EDT 2025 |
| IsDoiOpenAccess | true |
| IsOpenAccess | true |
| IsPeerReviewed | false |
| IsScholarly | true |
| Issue | 3 |
| Language | Japanese |
| License | https://creativecommons.org/licenses/by-nc/4.0/deed.ja |
| LinkModel | OpenURL |
| MergedId | FETCHMERGED-LOGICAL-j208a-3389c4ab2e848b7f491041bb01e69eb9f04f62863047a665b4d65ca87abdada3 |
| OpenAccessLink | https://www.jstage.jst.go.jp/article/jjgs/52/3/52_2018.0077/_article/-char/ja |
| PageCount | 10 |
| ParticipantIDs | jstage_primary_article_jjgs_52_3_52_2018_0077_article_char_ja |
| PublicationCentury | 2000 |
| PublicationDate | 2019/03/01 |
| PublicationDateYYYYMMDD | 2019-03-01 |
| PublicationDate_xml | – month: 03 year: 2019 text: 2019/03/01 day: 01 |
| PublicationDecade | 2010 |
| PublicationTitle | 日本消化器外科学会雑誌 |
| PublicationTitleAlternate | 日消外会誌 |
| PublicationYear | 2019 |
| Publisher | 一般社団法人 日本消化器外科学会 |
| Publisher_xml | – name: 一般社団法人 日本消化器外科学会 |
| References | 2) Murakami Y, Uemura K, Sudo T, Hashimoto Y, Nakashima A, Kondo N, et al. Prognostic factors of patients with advanced gallbladder carcinoma following aggressive surgical resection. J Gastrointest Surg. 2011;15(6):1007–1016. 25) Park I, Lee JL, Ryu MH, Kim TW, Chang HM, Lee SS, et al. Efficacy and safety of S-1 monotherapy in patients with advanced biliary tract adenocarcinoma: retrospective analysis of 162 patients. Oncology. 2009;76(2):126–132. 43) Agrawal S, Mohan L, Mourya C, Neyaz Z, Saxena R. Radiological downstaging with neoadjuvant therapy in unresectable gall bladder cancer cases. Asian Pac J Cancer Prev. 2016;17(4):2137–2140. 1) Miyakawa S, Ishihara S, Horiguchi A, Takada T, Miyazaki M, Nagakawa T. Biliary tract cancer treatment: 5,584 results from the Biliary Tract Cancer Statistics Registry from 1998 to 2004 in Japan. J Hepatobiliary Pancreat Surg. 2009;16(1):1–7. 15) Kondo S, Nimura Y, Hayakawa N, Kamiya J, Nagino M, Uesaka K. Regional and para-aortic lymphadenectomy in radical surgery for advanced gallbladder carcinoma. Br J Surg. 2000;87:418–422. 42) 遠藤 格，松山 隆生，森 隆太郎，田中 邦哉．胆嚢癌に対する外科治療の現況と今後の展望．日本消化器病学会雑誌．2013;110(8):1408–1414. 4) Ishihara S, Horiguchi A, Miyakawa S, Endo I, Miyazaki M, Takada T. Biliary tract cancer registry in Japan from 2008 to 2013. J Hepatobiliary Pancreat Sci. 2016;23:149–157. 37) Okumura T, Nakamura J, Kai K, Ide Y, Nakamura H, Koga H, et al. Curative resection of gallbladder cancer with liver invasion and hepatic metastasis after chemotherapy with gemcitabine plus S-1: report of a case. World J Surg Oncol. 2014;12:326. 18) Dorobisz T, Dorobisz K, Chabowski M, Pawłowski W, Janczak D, Patrzałek D, et al. Incidental gallbladder cancer after cholecystectomy: 1990 to 2014. Onco Targets Ther. 2016;9:4913–4916. 28) Kondo N, Murakami Y, Uemura K, Sudo T, Hashimoto Y, Nakagawa N, et al. A phase 1 study of gemcitabine/nab-paclitaxel/S-1 (GAS) combination neoadjuvant chemotherapy for patients with locally advanced pancreatic adenocarcinoma. Cancer Chemother Pharmacol. 2017;79(4):775–781. 14) Shimada H, Endo I, Togo S, Nakano A, Izumi T, Nakagawara G. The role of lymph node dissection in the treatment of gallbladder carcinoma. Cancer. 1997;79(5):892–899. 3) 日本肝胆膵外科学会，胆道癌診療ガイドライン作成委員会編．エビデンスに基づいた胆道癌診療ガイドライン．東京：医学図書出版；2014. p. 72–73. 12) Araida T, Higuchi R, Hamano M, Kodera Y, Takeshita N, Ota T, et al. Hepatic resection in 485 R0 pT2 and pT3 cases of advanced carcinoma of the gallbladder: results of a Japanese Society of Biliary Surgery survey—a multicenter study. J Hepatobiliary Pancreat Surg. 2009;16:204–215. 39) 味木 徹夫，松本 拓，篠崎 健太，村上 冴，木下 秘我，後藤 直大，ほか．化学療法が奏効し切除可能となった多発肝転移を伴う胆嚢癌の1例．癌と化学療法．2015;42(12):1500–1502. 23) Sasaki T, Isayama H, Nakai Y, Ito Y, Yasuda I, Toda N, et al. Treatment outcomes of chemotherapy between unresectable and recurrent biliary tract cancer. World J Gastroenterol. 2014;20(48):18452–18457. 33) Murakami Y, Uemura K, Sudo T, Hashimoto Y, Nakashima A, Sakabe R, et al. Adjuvant chemotherapy with gemcitabine and S-1 after surgical resection for advanced biliary carcinoma: outcomes and prognostic factors. J Hepatobiliary Pancreat Sci. 2012;19(4):306–313. 6) Kato A, Shimizu H, Ohtsuka M, Yoshitomi H, Furukawa K, Takayashiki T, et al. Downsizing chemotherapy for initially unresectable locally advanced biliary tract cancer patients treated with gemcitabine plus cisplatin combination therapy followed by radical surgery. Ann Surg Oncol. 2015;22:S1093–9. 29) Satoi S, Fujii T, Yanagimoto H, Motoi F, Kurata M, Takahara N, et al. Multicenter phase II study of intravenous and intraperitoneal paclitaxel with S-1 for pancreatic ductal adenocarcinoma patients with peritoneal metastasis. Ann Surg. 2017;265(2):397–401. 40) 上野 太輔，中島 洋，中島 義博，吉田 浩司，日野 啓輔，伊禮 功，ほか．集学的治療で長期予後が得られた大動脈周囲リンパ節転移・肝転移を伴う進行胆嚢癌の1例．胆道．2016;30(2):241–250. 9) Shukla PJ, Barreto G, Kakade A, Shrikhande SV. Revision surgery for incidental gallbladder cancer: factors influencing operability and further evidence for T1b tumours. HPB (Oxford). 2008;10(1):43–47. 13) Chen C, Geng Z, Shen H, Song H, Zhao Y, Zhang G, et al. Long-term outcomes and prognostic factors in advanced gallbladder cancer: focus on the advanced T stage. PLoS One. 2016;11(11):e0166361. 27) Okusaka T, Ishii H, Funakoshi A, Yamao K, Ohkawa S, Saito S, et al. Phase II study of single-agent gemcitabine in patients with advanced biliary tract cancer. Cancer Chemother Pharmacol. 2006;57(5):647–653. 21) Sasaki T, Isayama H, Nakai Y, Ito Y, Kogure H, Togawa O, et al. Multicenter, phase II study of gemcitabine and S-1 combination chemotherapy in patients with advanced biliary tract cancer. Cancer Chemother Pharmacol. 2010;65(6):1101–1107. 10) Wakai T, Shirai Y, Hatakeyama K. Radical second resection provides survival benefit for patients with T2 gallbladder carcinoma first discovered after laparoscopic cholecystectomy. World J Surg. 2002;26(7):867–871. 30) Satoi S, Yamaue H, Kato K, Takahashi S, Hirono S, Takeda S, et al. Role of adjuvant surgery for patients with initially unresectable pancreatic cancer with a long-term favorable response to non-surgical anti-cancer treatments: results of a project study for pancreatic surgery by the Japanese Society of Hepato-Biliary-Pancreatic Surgery. J Hepatobiliary Pancreat Sci. 2013;20(6):590–600. 26) Penz M, Kornek GV, Raderer M, Ulrich-Pur H, Fiebiger W, Lenauer A, et al. Phase II trial of two-weekly gemcitabine in patients with advanced biliary tract cancer. Ann Oncol. 2001;12(2):183–186. 5) Kato A, Shimizu H, Ohtsuka M, Yoshidome H, Yoshitomi H, Furukawa K, et al. Surgical resection after downsizing chemotherapy for initially unresectable locally advanced biliary tract cancer: a retrospective single-center study. Ann Surg Oncol. 2013;20(1):318–324. 22) Kanai M, Yoshimura K, Tsumura T, Asada M, Suzuki C, Niimi M, et al. A multi-institution phase II study of gemcitabine/S-1 combination chemotherapy for patients with advanced biliary tract cancer. Cancer Chemother Pharmacol. 2011;67(6):1429–1434. 20) Okusaka T, Nakachi K, Fukutomi A, Mizuno N, Ohkawa S, Funakoshi A, et al. Gemcitabine alone or in combination with cisplatin in patients with biliary tract cancer: a comparative multicentre study in Japan. Br J Cancer. 2010;103(4):469–474. 41) Somasekar R, Naganathbabu O, Prabhakaran R, Gnanasekar M, Kannan DG. Salvage surgery for metastatic gall bladder cancer with vanishing liver metastasis following palliative 5-fluorouracil metronomic chemotherapy. J Clin Diagn Res. 2017;11(5):XD03–5. 16) Chijiiwa K, Nakano K, Ueda J, Noshiro H, Nagai E, Yamaguchi K, et al. Surgical treatment of patients with T2 gallbladder carcinoma invading the subserosal layer. J Am Coll Surg. 2001;192(5):600–607. 31) Murakami Y, Uemura K, Sudo T, Hayashidani Y, Hashimoto Y, Nakamura H, et al. Adjuvant gemcitabine plus S-1 chemotherapy improves survival after aggressive surgical resection for advanced biliary carcinoma. Ann Surg. 2009;250(6):950–956. 36) Morimoto H, Ajiki T, Takase S, Fujita T, Matsumoto T, Mita Y, et al. Resection of gallbladder cancer with hepatic metastasis after chemotherapy with gemcitabine. J Hepatobiliary Pancreat Surg. 2008;15(6):655–658. 8) Zhang WJ, Xu GF, Zou XP, Wang WB, Yu JC, Wu GZ, et al. Incidental gallbladder carcinoma diagnosed during or after laparoscopic cholecystectomy. World J Surg. 2009;33(12):2651–2656. 32) Murakami Y, Uemura K, Sudo T, Hayashidani Y, Hashimoto Y, Nakamura H, et al. Gemcitabine-based adjuvant chemotherapy improves survival after aggressive surgery for hilar cholangiocarcinoma. J Gastrointest Surg. 2009;13(8):1470–1479. 11) Horiguchi A, Miyakawa S, Ishihara S, Miyazaki M, Ohtsuka M, Shimizu H, et al. Gallbladder bed resection or hepatectomy of segments 4a and 5 for pT2 gallbladder carcinoma: analysis of Japanese registration cases by the study group for biliary surgery of the Japanese Society of Hepato-Biliary-Pancreatic Surgery. J Hepatobiliary Pancreat Sci. 2013;20(5):518–524. 24) Furuse J, Okusaka T, Boku N, Ohkawa S, Sawaki A, Masumoto T, et al. S-1 monotherapy as first-line treatment in patients with advanced biliary tract cancer: a multicenter phase II study. Cancer Chemother Pharmacol. 2008;62(5):849–855. 34) Siebenhüner AR, Seifert H, Bachmann H, Seifert B, Winder T, Feilchenfeldt J, et al. Adjuvant treatment of resectable biliary tract cancer with cisplatin plus gemcitabine: a prospective single center phase II study. BMC Cancer. 2018;18(1):72. 17) Choi SB, Han HJ, Kim CY, Kim WB, Song TJ, Suh SO, et al. Surgical outcomes and prognostic factors for T2 gallbladder cancer following surgical resection. J Gastrointest Surg. 2010;14(4):668–678. 35) 大塚 将之，清水 宏明，加藤 厚，宮崎 勝．切除不能進行胆道癌に対するConversion surgery．胆道．2017;31(4):691–696. 38) 谷 聡，山岸 沙莉，福永 馨，森田 宗孝，園田 隆，村尾 眞一，ほか．CDDP/CPT-11療法が奏効し切除し得た肝転移を伴う胆嚢混合型腺神経内分泌癌の1例．癌と化学療法．2015;42(1):113–117. 19) Valle J, Wasan H, Palmer DH, Cunningham D, Anthoney A, Maraveyas A. Cisplatin plus gemcitabine versus gemcitabine for biliary tract cancer. N Engl J Med. 2010;362(14):1273–1281. 7) Choi SB, Han HJ, Kim CY, Kim WB, Song TJ, Suh SO, et al. Incidental gallbladder cancer diagnosed following laparoscopic cholecystectomy. World J Surg. 2009;33(12):2657–2663. |
| References_xml | – reference: 9) Shukla PJ, Barreto G, Kakade A, Shrikhande SV. Revision surgery for incidental gallbladder cancer: factors influencing operability and further evidence for T1b tumours. HPB (Oxford). 2008;10(1):43–47. – reference: 11) Horiguchi A, Miyakawa S, Ishihara S, Miyazaki M, Ohtsuka M, Shimizu H, et al. Gallbladder bed resection or hepatectomy of segments 4a and 5 for pT2 gallbladder carcinoma: analysis of Japanese registration cases by the study group for biliary surgery of the Japanese Society of Hepato-Biliary-Pancreatic Surgery. J Hepatobiliary Pancreat Sci. 2013;20(5):518–524. – reference: 22) Kanai M, Yoshimura K, Tsumura T, Asada M, Suzuki C, Niimi M, et al. A multi-institution phase II study of gemcitabine/S-1 combination chemotherapy for patients with advanced biliary tract cancer. Cancer Chemother Pharmacol. 2011;67(6):1429–1434. – reference: 36) Morimoto H, Ajiki T, Takase S, Fujita T, Matsumoto T, Mita Y, et al. Resection of gallbladder cancer with hepatic metastasis after chemotherapy with gemcitabine. J Hepatobiliary Pancreat Surg. 2008;15(6):655–658. – reference: 18) Dorobisz T, Dorobisz K, Chabowski M, Pawłowski W, Janczak D, Patrzałek D, et al. Incidental gallbladder cancer after cholecystectomy: 1990 to 2014. Onco Targets Ther. 2016;9:4913–4916. – reference: 21) Sasaki T, Isayama H, Nakai Y, Ito Y, Kogure H, Togawa O, et al. Multicenter, phase II study of gemcitabine and S-1 combination chemotherapy in patients with advanced biliary tract cancer. Cancer Chemother Pharmacol. 2010;65(6):1101–1107. – reference: 28) Kondo N, Murakami Y, Uemura K, Sudo T, Hashimoto Y, Nakagawa N, et al. A phase 1 study of gemcitabine/nab-paclitaxel/S-1 (GAS) combination neoadjuvant chemotherapy for patients with locally advanced pancreatic adenocarcinoma. Cancer Chemother Pharmacol. 2017;79(4):775–781. – reference: 33) Murakami Y, Uemura K, Sudo T, Hashimoto Y, Nakashima A, Sakabe R, et al. Adjuvant chemotherapy with gemcitabine and S-1 after surgical resection for advanced biliary carcinoma: outcomes and prognostic factors. J Hepatobiliary Pancreat Sci. 2012;19(4):306–313. – reference: 13) Chen C, Geng Z, Shen H, Song H, Zhao Y, Zhang G, et al. Long-term outcomes and prognostic factors in advanced gallbladder cancer: focus on the advanced T stage. PLoS One. 2016;11(11):e0166361. – reference: 19) Valle J, Wasan H, Palmer DH, Cunningham D, Anthoney A, Maraveyas A. Cisplatin plus gemcitabine versus gemcitabine for biliary tract cancer. N Engl J Med. 2010;362(14):1273–1281. – reference: 24) Furuse J, Okusaka T, Boku N, Ohkawa S, Sawaki A, Masumoto T, et al. S-1 monotherapy as first-line treatment in patients with advanced biliary tract cancer: a multicenter phase II study. Cancer Chemother Pharmacol. 2008;62(5):849–855. – reference: 35) 大塚 将之，清水 宏明，加藤 厚，宮崎 勝．切除不能進行胆道癌に対するConversion surgery．胆道．2017;31(4):691–696. – reference: 42) 遠藤 格，松山 隆生，森 隆太郎，田中 邦哉．胆嚢癌に対する外科治療の現況と今後の展望．日本消化器病学会雑誌．2013;110(8):1408–1414. – reference: 37) Okumura T, Nakamura J, Kai K, Ide Y, Nakamura H, Koga H, et al. Curative resection of gallbladder cancer with liver invasion and hepatic metastasis after chemotherapy with gemcitabine plus S-1: report of a case. World J Surg Oncol. 2014;12:326. – reference: 1) Miyakawa S, Ishihara S, Horiguchi A, Takada T, Miyazaki M, Nagakawa T. Biliary tract cancer treatment: 5,584 results from the Biliary Tract Cancer Statistics Registry from 1998 to 2004 in Japan. J Hepatobiliary Pancreat Surg. 2009;16(1):1–7. – reference: 38) 谷 聡，山岸 沙莉，福永 馨，森田 宗孝，園田 隆，村尾 眞一，ほか．CDDP/CPT-11療法が奏効し切除し得た肝転移を伴う胆嚢混合型腺神経内分泌癌の1例．癌と化学療法．2015;42(1):113–117. – reference: 27) Okusaka T, Ishii H, Funakoshi A, Yamao K, Ohkawa S, Saito S, et al. Phase II study of single-agent gemcitabine in patients with advanced biliary tract cancer. Cancer Chemother Pharmacol. 2006;57(5):647–653. – reference: 32) Murakami Y, Uemura K, Sudo T, Hayashidani Y, Hashimoto Y, Nakamura H, et al. Gemcitabine-based adjuvant chemotherapy improves survival after aggressive surgery for hilar cholangiocarcinoma. J Gastrointest Surg. 2009;13(8):1470–1479. – reference: 43) Agrawal S, Mohan L, Mourya C, Neyaz Z, Saxena R. Radiological downstaging with neoadjuvant therapy in unresectable gall bladder cancer cases. Asian Pac J Cancer Prev. 2016;17(4):2137–2140. – reference: 8) Zhang WJ, Xu GF, Zou XP, Wang WB, Yu JC, Wu GZ, et al. Incidental gallbladder carcinoma diagnosed during or after laparoscopic cholecystectomy. World J Surg. 2009;33(12):2651–2656. – reference: 15) Kondo S, Nimura Y, Hayakawa N, Kamiya J, Nagino M, Uesaka K. Regional and para-aortic lymphadenectomy in radical surgery for advanced gallbladder carcinoma. Br J Surg. 2000;87:418–422. – reference: 23) Sasaki T, Isayama H, Nakai Y, Ito Y, Yasuda I, Toda N, et al. Treatment outcomes of chemotherapy between unresectable and recurrent biliary tract cancer. World J Gastroenterol. 2014;20(48):18452–18457. – reference: 16) Chijiiwa K, Nakano K, Ueda J, Noshiro H, Nagai E, Yamaguchi K, et al. Surgical treatment of patients with T2 gallbladder carcinoma invading the subserosal layer. J Am Coll Surg. 2001;192(5):600–607. – reference: 30) Satoi S, Yamaue H, Kato K, Takahashi S, Hirono S, Takeda S, et al. Role of adjuvant surgery for patients with initially unresectable pancreatic cancer with a long-term favorable response to non-surgical anti-cancer treatments: results of a project study for pancreatic surgery by the Japanese Society of Hepato-Biliary-Pancreatic Surgery. J Hepatobiliary Pancreat Sci. 2013;20(6):590–600. – reference: 14) Shimada H, Endo I, Togo S, Nakano A, Izumi T, Nakagawara G. The role of lymph node dissection in the treatment of gallbladder carcinoma. Cancer. 1997;79(5):892–899. – reference: 41) Somasekar R, Naganathbabu O, Prabhakaran R, Gnanasekar M, Kannan DG. Salvage surgery for metastatic gall bladder cancer with vanishing liver metastasis following palliative 5-fluorouracil metronomic chemotherapy. J Clin Diagn Res. 2017;11(5):XD03–5. – reference: 29) Satoi S, Fujii T, Yanagimoto H, Motoi F, Kurata M, Takahara N, et al. Multicenter phase II study of intravenous and intraperitoneal paclitaxel with S-1 for pancreatic ductal adenocarcinoma patients with peritoneal metastasis. Ann Surg. 2017;265(2):397–401. – reference: 2) Murakami Y, Uemura K, Sudo T, Hashimoto Y, Nakashima A, Kondo N, et al. Prognostic factors of patients with advanced gallbladder carcinoma following aggressive surgical resection. J Gastrointest Surg. 2011;15(6):1007–1016. – reference: 10) Wakai T, Shirai Y, Hatakeyama K. Radical second resection provides survival benefit for patients with T2 gallbladder carcinoma first discovered after laparoscopic cholecystectomy. World J Surg. 2002;26(7):867–871. – reference: 3) 日本肝胆膵外科学会，胆道癌診療ガイドライン作成委員会編．エビデンスに基づいた胆道癌診療ガイドライン．東京：医学図書出版；2014. p. 72–73. – reference: 17) Choi SB, Han HJ, Kim CY, Kim WB, Song TJ, Suh SO, et al. Surgical outcomes and prognostic factors for T2 gallbladder cancer following surgical resection. J Gastrointest Surg. 2010;14(4):668–678. – reference: 25) Park I, Lee JL, Ryu MH, Kim TW, Chang HM, Lee SS, et al. Efficacy and safety of S-1 monotherapy in patients with advanced biliary tract adenocarcinoma: retrospective analysis of 162 patients. Oncology. 2009;76(2):126–132. – reference: 26) Penz M, Kornek GV, Raderer M, Ulrich-Pur H, Fiebiger W, Lenauer A, et al. Phase II trial of two-weekly gemcitabine in patients with advanced biliary tract cancer. Ann Oncol. 2001;12(2):183–186. – reference: 20) Okusaka T, Nakachi K, Fukutomi A, Mizuno N, Ohkawa S, Funakoshi A, et al. Gemcitabine alone or in combination with cisplatin in patients with biliary tract cancer: a comparative multicentre study in Japan. Br J Cancer. 2010;103(4):469–474. – reference: 5) Kato A, Shimizu H, Ohtsuka M, Yoshidome H, Yoshitomi H, Furukawa K, et al. Surgical resection after downsizing chemotherapy for initially unresectable locally advanced biliary tract cancer: a retrospective single-center study. Ann Surg Oncol. 2013;20(1):318–324. – reference: 4) Ishihara S, Horiguchi A, Miyakawa S, Endo I, Miyazaki M, Takada T. Biliary tract cancer registry in Japan from 2008 to 2013. J Hepatobiliary Pancreat Sci. 2016;23:149–157. – reference: 31) Murakami Y, Uemura K, Sudo T, Hayashidani Y, Hashimoto Y, Nakamura H, et al. Adjuvant gemcitabine plus S-1 chemotherapy improves survival after aggressive surgical resection for advanced biliary carcinoma. Ann Surg. 2009;250(6):950–956. – reference: 40) 上野 太輔，中島 洋，中島 義博，吉田 浩司，日野 啓輔，伊禮 功，ほか．集学的治療で長期予後が得られた大動脈周囲リンパ節転移・肝転移を伴う進行胆嚢癌の1例．胆道．2016;30(2):241–250. – reference: 7) Choi SB, Han HJ, Kim CY, Kim WB, Song TJ, Suh SO, et al. Incidental gallbladder cancer diagnosed following laparoscopic cholecystectomy. World J Surg. 2009;33(12):2657–2663. – reference: 6) Kato A, Shimizu H, Ohtsuka M, Yoshitomi H, Furukawa K, Takayashiki T, et al. Downsizing chemotherapy for initially unresectable locally advanced biliary tract cancer patients treated with gemcitabine plus cisplatin combination therapy followed by radical surgery. Ann Surg Oncol. 2015;22:S1093–9. – reference: 39) 味木 徹夫，松本 拓，篠崎 健太，村上 冴，木下 秘我，後藤 直大，ほか．化学療法が奏効し切除可能となった多発肝転移を伴う胆嚢癌の1例．癌と化学療法．2015;42(12):1500–1502. – reference: 12) Araida T, Higuchi R, Hamano M, Kodera Y, Takeshita N, Ota T, et al. Hepatic resection in 485 R0 pT2 and pT3 cases of advanced carcinoma of the gallbladder: results of a Japanese Society of Biliary Surgery survey—a multicenter study. J Hepatobiliary Pancreat Surg. 2009;16:204–215. – reference: 34) Siebenhüner AR, Seifert H, Bachmann H, Seifert B, Winder T, Feilchenfeldt J, et al. Adjuvant treatment of resectable biliary tract cancer with cisplatin plus gemcitabine: a prospective single center phase II study. BMC Cancer. 2018;18(1):72. |
| SSID | ssib005879761 ssib000936942 ssib023160767 ssib058493923 ssj0000491391 ssib002223853 |
| Score | 2.1999078 |
| Snippet | 症例は73歳の女性で，腹腔鏡下胆囊摘出術後のpT2（SS）偶発胆囊癌のため肝床部切除術が追加された．しかし，術中肝切離面には多数の微少結節を認め，術後病理検... |
| SourceID | jstage |
| SourceType | Publisher |
| StartPage | 166 |
| SubjectTerms | conversion surgery 偶発胆囊癌 術前化学療法 |
| Title | 3度の手術を含む集学的治療によりR0切除しえたStage IVB偶発胆囊癌の1例 |
| URI | https://www.jstage.jst.go.jp/article/jjgs/52/3/52_2018.0077/_article/-char/ja |
| Volume | 52 |
| hasFullText | 1 |
| inHoldings | 1 |
| isFullTextHit | |
| isPrint | |
| ispartofPNX | 日本消化器外科学会雑誌, 2019/03/01, Vol.52(3), pp.166-175 |
| journalDatabaseRights | – providerCode: PRVAFT databaseName: Open Access Digital Library customDbUrl: eissn: 1348-9372 dateEnd: 99991231 omitProxy: true ssIdentifier: ssj0000491391 issn: 0386-9768 databaseCode: KQ8 dateStart: 19690101 isFulltext: true titleUrlDefault: http://grweb.coalliance.org/oadl/oadl.html providerName: Colorado Alliance of Research Libraries |
| link | http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwrR09b9NA1KrKwoJAgPhWB26qDLbPPt8NDOfgqIBAoiqoE5YvdpAyFATpwkQCKqVlQDCg0AEhoS4IBgaGIvFnTJr2X_DenZ24iIECUmSd3r17n7m89y6-O8s6DzkxVypo20yFyvZhBtkQBDM74G4apnjZrT634PoNNnfLv7oYLE5Np7W3lpa76kLr0W_3lfyNVwEGfsVdsvvw7JgoAKAN_oUneBief-RjSuKARJJIRmIKOSGRMYkZ4YLwiMScSJcIqrs8IjxEFg6RUQnhDokFERHhDLvkZU0nJEIS7iOdyCNRpCEC8UsW4-G8ash5BwkAgIeapCDSL9FFWDZKdIA0IcG9m89euR3pUS6JWMkEVAGpOS0lQtFkxb8xVtElsU-iGHSsZ9YoMDCTgW40iGxoFZhmHOB4YYiCcBoCIgrNWAIDt2YBIN5AIxjjYBdYEmwyXk_WKJKIQDc4Cglf1MqYgWbXBOtN8IEDYDoaPyKSGnyOLaHxoY_LOj44BzXQPVFs8GFwE31q_BjFE3yBgqM2XNvAN_iMyCYxVxVVCzu4l4zWF3YqFRxtea6ZagrA1LgAZERD0kpfCZ_Z_27tWkCinNmQvpp4mZuASX2Os3tPRA282i8HrYVHl7FapuWaO3N-DeK4DxCDeOcuHqfv4rvO5U0_ew9GL6ddgohJ4CUUHzggwQFJ1Y27F5MOlFAHvJAxvOTk2s1aBYIXWvq1FwsgXa5nsAEPQeNxCIRqiDnhJGOH9F3QagWiYwpuqKn0PZ2VtcxRsajVxb06QdLbedgdvz6qM9qFw9ahshSdkUaDI9ZUJz1q3aHDrc2i93n7-frO-9dF_9Xw5cei_3h3Y2X4aXP09un2l2-jQb_oAXC16K_NO8PVZ7uDD0XvTdFbLXrv9Nyegbk97H0dDbZ2nqwMN9ZGgxdA0v3xff2YtdCMFxpzdnkHi93xHJ7aFAqalp8qL-c-V2Eb1HN8VynHzZnIlWg7fht3t-O_9yljgfIzFrRSHqYqS7OUHreml-4t5SesmTB1lcPaPBCtzHdUm-dZ5nE3d1shpW3unLQuGWsk9805O8n-HHzqH8eftg5OZuEZa7r7YDk_CwVHV53TX5mfj3nqlg |
| linkProvider | Colorado Alliance of Research Libraries |
| openUrl | ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=3%E5%BA%A6%E3%81%AE%E6%89%8B%E8%A1%93%E3%82%92%E5%90%AB%E3%82%80%E9%9B%86%E5%AD%A6%E7%9A%84%E6%B2%BB%E7%99%82%E3%81%AB%E3%82%88%E3%82%8AR0%E5%88%87%E9%99%A4%E3%81%97%E3%81%88%E3%81%9FStage+IVB%E5%81%B6%E7%99%BA%E8%83%86%E5%9B%8A%E7%99%8C%E3%81%AE1%E4%BE%8B&rft.jtitle=%E6%97%A5%E6%9C%AC%E6%B6%88%E5%8C%96%E5%99%A8%E5%A4%96%E7%A7%91%E5%AD%A6%E4%BC%9A%E9%9B%91%E8%AA%8C&rft.au=%E4%BA%95%E4%B8%8A%2C+%E9%9B%85%E5%8F%B2&rft.au=%E7%94%B0%E4%BB%A3%2C+%E8%A3%95%E5%B0%8A&rft.au=%E7%80%AC%E5%B0%BE%2C+%E4%BF%A1%E5%90%BE&rft.au=%E9%A6%96%E8%97%A4%2C+%E6%AF%85&rft.date=2019-03-01&rft.pub=%E4%B8%80%E8%88%AC%E7%A4%BE%E5%9B%A3%E6%B3%95%E4%BA%BA+%E6%97%A5%E6%9C%AC%E6%B6%88%E5%8C%96%E5%99%A8%E5%A4%96%E7%A7%91%E5%AD%A6%E4%BC%9A&rft.issn=0386-9768&rft.eissn=1348-9372&rft.volume=52&rft.issue=3&rft.spage=166&rft.epage=175&rft_id=info:doi/10.5833%2Fjjgs.2018.0077&rft.externalDocID=article_jjgs_52_3_52_2018_0077_article_char_ja |
| thumbnail_l | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=0386-9768&client=summon |
| thumbnail_m | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=0386-9768&client=summon |
| thumbnail_s | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=0386-9768&client=summon |