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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 3/2015

01-12-2015 | Hepatobiliary Tumors

Downsizing Chemotherapy for Initially Unresectable Locally Advanced Biliary Tract Cancer Patients Treated with Gemcitabine Plus Cisplatin Combination Therapy Followed by Radical Surgery

Authors: Atsushi Kato, MD, PhD, Hiroaki Shimizu, MD, PhD, Masayuki Ohtsuka, MD, PhD, Hideyuki Yoshitomi, MD, PhD, Katsunori Furukawa, MD, PhD, Tsukasa Takayashiki, MD, PhD, Eri Nakadai, MD, Takashi Kishimoto, MD, PhD, Yukio Nakatani, MD, PhD, Hiroyuki Yoshidome, MD, PhD, Masaru Miyazaki, MD, PhD

Published in: Annals of Surgical Oncology | Special Issue 3/2015

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Abstract

Backgound

We have treated patients with initially unresectable locally advanced biliary tract cancer (BTC) by administering gemcitabine and have found that surgical resection became feasible in some downsized patients. The aim of this study was to investigate the usefulness of downsizing combination chemotherapy using gemcitabine plus cisplatin to treat initially unresectable locally advanced BTC.

Methods

The subjects of the study were 150 consecutive patients who were treated for BTC between October 2011 and April 2014. Downsizing chemotherapy was carried out for 39 patients (26.0 %) whose lesions were unresectable because of locally advanced BTC.

Results

Reduction in tumor size with downsizing chemotherapy was seen in 18 patients, and surgical resection was performed in 10 of 39 patients (25.6 %). Median survival time in patients with surgical resection following downsizing chemotherapy and those with chemotherapy alone was 17.9 and 12.4 months, respectively (p = 0.0378). According to the historical comparison between gemcitabine and gemcitabine plus cisplatin chemotherapy, there is no significant difference in overall survival. However, there was a significant difference for the pathologic response rate (≥Grade III) to be higher in patients with gemcitabine plus cisplatin chemotherapy compared with gemcitabine monotherapy.

Conclusions

Preoperative downsizing chemotherapy with gemcitabine plus cisplatin provides longer survival by the conversion to the surgical resection in patients with initially unresectable locally advanced BTC. It may have the potential for disease eradication as a new multidisciplinary approach for initially unresectable locally advanced BTC.
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Metadata
Title
Downsizing Chemotherapy for Initially Unresectable Locally Advanced Biliary Tract Cancer Patients Treated with Gemcitabine Plus Cisplatin Combination Therapy Followed by Radical Surgery
Authors
Atsushi Kato, MD, PhD
Hiroaki Shimizu, MD, PhD
Masayuki Ohtsuka, MD, PhD
Hideyuki Yoshitomi, MD, PhD
Katsunori Furukawa, MD, PhD
Tsukasa Takayashiki, MD, PhD
Eri Nakadai, MD
Takashi Kishimoto, MD, PhD
Yukio Nakatani, MD, PhD
Hiroyuki Yoshidome, MD, PhD
Masaru Miyazaki, MD, PhD
Publication date
01-12-2015
Publisher
Springer US
Published in
Annals of Surgical Oncology / Issue Special Issue 3/2015
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-015-4768-9

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