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Successful curative resection of gallbladder cancer following S-1 chemotherapy: A case report and review of the literature.

Einama T, Uchida K, Taniguchi M, Ota Y, Watanabe K, Imai K, Karasaki H, Chiba A, Oikawa K, Miyokawa N, Furukawa H - Oncol Lett (2014)

Bottom Line: The most effective treatment for GBC is surgical resection, however the majority of GBC cases are unresectable at the time of diagnosis.The surgical specimen exhibited high intratumoral DPD gene expression levels compared with those observed in previously reported non S-1 responsive cases of biliary tract cancer.Due to the results obtained in the current study, we hypothesize that CDHP enhanced the antitumor efficacy of 5-FU by inhibiting the excess DPD protein produced by the tumor.

View Article: PubMed Central - PubMed

Affiliation: Division of Gastroenterological and General Surgery, Asahikawa Medical University, Asahikawa, Hokkaido 078-8510, Japan ; Department of Surgery, Hokkaido Social Work Association Obihiro Hospital, Obihiro, Hokkaido 080-0805, Japan.

ABSTRACT
The symptoms of gallbladder cancer (GBC) are vague and non-specific. Therefore, GBC is often detected at an advanced or metastatic stage. The most effective treatment for GBC is surgical resection, however the majority of GBC cases are unresectable at the time of diagnosis. Therefore, numerous GBC patients undergo chemotherapy. This study reports the case of a 60-year-old female with GBC who underwent successful surgical curative resection following a single dose of the chemotherapeutic agent, S-1, twice daily for 4 weeks followed by a 14-day rest period for 36 months. S-1 is a novel orally administered drug composed of a combination of the 5-fluorouracil (5-FU) prodrug, tegafur, 5-chloro-2,4-dihydroxypyridine (CDHP) and oteracil potassium in a 1:0.4:1 molar concentration ratio. The focus of the present study was the candidate factors that affect the therapeutic efficacy of S-1-based chemotherapy. In particular, the gene expression involved in the S-1 metabolic pathway was investigated by assessing the intratumoral dihydropyrimidine dehydrogenase (DPD), thymidylate synthase (TS) and orotate phosphoribosyltransferase gene expression. The surgical specimen exhibited high intratumoral DPD gene expression levels compared with those observed in previously reported non S-1 responsive cases of biliary tract cancer. Due to the results obtained in the current study, we hypothesize that CDHP enhanced the antitumor efficacy of 5-FU by inhibiting the excess DPD protein produced by the tumor.

No MeSH data available.


Related in: MedlinePlus

Pathological examination demonstrated that the tumor was (A) a scirrhous adenocarcinoma and (B) predominantly consisted of fibrosis and necrosis tissue [stain, hematoxylin and eosin; magnification (A) ×200 and (B) ×40.
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f4-ol-08-06-2443: Pathological examination demonstrated that the tumor was (A) a scirrhous adenocarcinoma and (B) predominantly consisted of fibrosis and necrosis tissue [stain, hematoxylin and eosin; magnification (A) ×200 and (B) ×40.

Mentions: The patient underwent percutaneous transhepatic portal embolization and, three weeks following this, a right lobectomy with extrabiliary duct resection and lymphadenectomy was performed. The pathological findings of the tumor were compatible with a diagnosis of adenocarcinoma of the gallbladder. The tumor had directly invaded the liver and cancer cells were found in the perineural area; however there was no metastatic lesion in the liver and no regional lymph node metastasis. All surgical margins were negative (Fig. 4) and a pathological R0 resection was achieved. The postoperative course was uneventful, and the patient was discharged 25 days following surgery.


Successful curative resection of gallbladder cancer following S-1 chemotherapy: A case report and review of the literature.

Einama T, Uchida K, Taniguchi M, Ota Y, Watanabe K, Imai K, Karasaki H, Chiba A, Oikawa K, Miyokawa N, Furukawa H - Oncol Lett (2014)

Pathological examination demonstrated that the tumor was (A) a scirrhous adenocarcinoma and (B) predominantly consisted of fibrosis and necrosis tissue [stain, hematoxylin and eosin; magnification (A) ×200 and (B) ×40.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4214413&req=5

f4-ol-08-06-2443: Pathological examination demonstrated that the tumor was (A) a scirrhous adenocarcinoma and (B) predominantly consisted of fibrosis and necrosis tissue [stain, hematoxylin and eosin; magnification (A) ×200 and (B) ×40.
Mentions: The patient underwent percutaneous transhepatic portal embolization and, three weeks following this, a right lobectomy with extrabiliary duct resection and lymphadenectomy was performed. The pathological findings of the tumor were compatible with a diagnosis of adenocarcinoma of the gallbladder. The tumor had directly invaded the liver and cancer cells were found in the perineural area; however there was no metastatic lesion in the liver and no regional lymph node metastasis. All surgical margins were negative (Fig. 4) and a pathological R0 resection was achieved. The postoperative course was uneventful, and the patient was discharged 25 days following surgery.

Bottom Line: The most effective treatment for GBC is surgical resection, however the majority of GBC cases are unresectable at the time of diagnosis.The surgical specimen exhibited high intratumoral DPD gene expression levels compared with those observed in previously reported non S-1 responsive cases of biliary tract cancer.Due to the results obtained in the current study, we hypothesize that CDHP enhanced the antitumor efficacy of 5-FU by inhibiting the excess DPD protein produced by the tumor.

View Article: PubMed Central - PubMed

Affiliation: Division of Gastroenterological and General Surgery, Asahikawa Medical University, Asahikawa, Hokkaido 078-8510, Japan ; Department of Surgery, Hokkaido Social Work Association Obihiro Hospital, Obihiro, Hokkaido 080-0805, Japan.

ABSTRACT
The symptoms of gallbladder cancer (GBC) are vague and non-specific. Therefore, GBC is often detected at an advanced or metastatic stage. The most effective treatment for GBC is surgical resection, however the majority of GBC cases are unresectable at the time of diagnosis. Therefore, numerous GBC patients undergo chemotherapy. This study reports the case of a 60-year-old female with GBC who underwent successful surgical curative resection following a single dose of the chemotherapeutic agent, S-1, twice daily for 4 weeks followed by a 14-day rest period for 36 months. S-1 is a novel orally administered drug composed of a combination of the 5-fluorouracil (5-FU) prodrug, tegafur, 5-chloro-2,4-dihydroxypyridine (CDHP) and oteracil potassium in a 1:0.4:1 molar concentration ratio. The focus of the present study was the candidate factors that affect the therapeutic efficacy of S-1-based chemotherapy. In particular, the gene expression involved in the S-1 metabolic pathway was investigated by assessing the intratumoral dihydropyrimidine dehydrogenase (DPD), thymidylate synthase (TS) and orotate phosphoribosyltransferase gene expression. The surgical specimen exhibited high intratumoral DPD gene expression levels compared with those observed in previously reported non S-1 responsive cases of biliary tract cancer. Due to the results obtained in the current study, we hypothesize that CDHP enhanced the antitumor efficacy of 5-FU by inhibiting the excess DPD protein produced by the tumor.

No MeSH data available.


Related in: MedlinePlus