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<p>Standard treatment for metastatic biliary tract cancer is systemic chemotherapy, not local therapy, such as surgery or radiation therapy. This is because long-term survival is not expected with local therapy. We present the case of a 49-year-old man who underwent extended right hepatectomy with extrahepatic bile duct resection for hilar cholangiocarcinoma. Postoperative adjuvant chemotherapy with oral S-1 for six months was completed. At 20&#xa0;months post-operation, para-aortic lymphadenopathy was detected, and endoscopic ultrasound-guided biopsy confirmed lymph node recurrence. Gemcitabine and cisplatin were administered for six months, resulting in partial tumor regression. As no other lesions were identified, radiotherapy with a total dose of 55&#xa0;Gy in 22 fractions was performed. At 37&#xa0;months following the completion of radiotherapy, the patient remained disease-free based on imaging. This case suggests that the addition of local radiotherapy to systemic chemotherapy may be beneficial for patients with oligometastatic recurrence of hilar cholangiocarcinoma.</p>

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Long-term survival following chemoradiotherapy for postoperative recurrence of hilar cholangiocarcinoma

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年1月31日

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  • Kazuki Asakura,
  • Takahiro Einama,
  • Kazuki Kobayashi,
  • Hanae Shinada,
  • Naoto Yonamine,
  • Takazumi Tsunenari,
  • Mikiya Takao,
  • Saburo Matsubara,
  • Kazuyuki Oyama,
  • Yoji Kishi

摘要

Standard treatment for metastatic biliary tract cancer is systemic chemotherapy, not local therapy, such as surgery or radiation therapy. This is because long-term survival is not expected with local therapy. We present the case of a 49-year-old man who underwent extended right hepatectomy with extrahepatic bile duct resection for hilar cholangiocarcinoma. Postoperative adjuvant chemotherapy with oral S-1 for six months was completed. At 20 months post-operation, para-aortic lymphadenopathy was detected, and endoscopic ultrasound-guided biopsy confirmed lymph node recurrence. Gemcitabine and cisplatin were administered for six months, resulting in partial tumor regression. As no other lesions were identified, radiotherapy with a total dose of 55 Gy in 22 fractions was performed. At 37 months following the completion of radiotherapy, the patient remained disease-free based on imaging. This case suggests that the addition of local radiotherapy to systemic chemotherapy may be beneficial for patients with oligometastatic recurrence of hilar cholangiocarcinoma.