Long-term survival of a recurrent gallbladder carcinoma patient with lymph node and peritoneal metastases after multidisciplinary treatments: a case report.

Koichi Tomita,Naokazu Chiba,Toru Sano,Masaaki Okihara,Kiminori Takano,Shigeyuki Kawachi,Motohide Shimazu

doi:10.1186/s40792-016-0135-8

Koichi Tomita, Naokazu Chiba + Show 5 more

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https://doi.org/10.1186/s40792-016-0135-8

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BackgroundGallbladder carcinoma with peritoneal metastasis has a poor prognosis, with a median survival time of 4.8 months. We report the survival of a patient with gallbladder carcinoma with peritoneal metastasis for 7.6 months owing to treatment with tumor resection after chemoradiotherapy.Case presentationA 69-year-old man was referred to our hospital for gallbladder carcinoma with hepatic invasion. Cholecystectomy was performed along with S4a and S5 hepatectomy and extrahepatic bile duct resection with lymph node dissection. The postoperative pathological diagnosis was moderately differentiated adenocarcinoma, T3, N0, M0, stage IIIA by the International Union Against Cancer TNM classification. Despite treatment with gemcitabine, the common hepatic artery and para-aortic lymph nodes showed metastases after 3 months from surgery. Although a combination of cisplatin, gemcitabine, and radiotherapy reduced the size of the lymph node metastasis, the peritoneal metastasis persisted. The peritoneal metastasis responded to chemoradiotherapy using tegafur-uracil and leucovorin, but it recurred. The metastasis was resected after 3 years and 9 months from the first surgery, and chemotherapy was discontinued. Seven years and 6 months after the initial surgery, the patient exhibited no signs of tumor recurrence or metastasis.ConclusionsMultidisciplinary treatment including resection without residual tumors could achieve complete remission of gallbladder carcinoma with lymph node and peritoneal metastases in the selected patient.

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Gallbladder carcinoma with peritoneal metastasis has a poor prognosis, with a median survival time of 4.8 months
We report the survival of a patient with Gallbladder carcinoma (GBC) with lymph node and peritoneal metastasis for 7.6 months; this was achieved by controlling disease progression with chemoradiotherapy and resection of the peritoneal metastasis
In this report, we demonstrate a rare case of long-term disease-free survival in a patient with recurrent GBC with lymph node and peritoneal metastases by using multidisciplinary treatments including resection, chemotherapy, and radiotherapy

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Despite significant developments in the fields of chemotherapy and/or radiotherapy, resection without residual tumor might have an important role in improving the prognosis of recurrent GBC. Resection should be considered if the metastatic lesion is isolated and well controlled with chemoradiotherapy in order to achieve complete remission and/or long-term survival. Consent Written informed consent was obtained from the patient for publication of this case report and any accompanying images. Competing interests The authors declare that they have no competing interests. Authors’ contributions KTomita and KTakano made the conception and design of this case report. Authors other than KTomita and KTakano (MO, TS, NC, MS, SK) contributed to the collection, analysis, and interpretation of the data. KTomita and KTakano wrote the draft manuscript, and other authors performed the critical revision of the manuscript.

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