Although hepatic metastasis after operation for gallbladder carcinoma occurs in a high frequency, no effective therapy has been established as yet. We experienced a case of hepatic metastasis after operation for a gallbladder carcinoma in which WHF (weekly high dose 5-FU hepatic arterial infusion) regimen was extremely effective, resulting in a complete remission (CR).
A 29-year-old man underwent a resection of the gallbladder bed and pancreatoduodenectomy for a gallbladder carcinoma and metastasis to lymph nodes of the pancreatic head on February 27, 1995. Eight months after the operation, along with an increase in CA19-9, metastasis to the S4 of the liver was found with CT and ultrasonography (US). A subcutaneous implant reservoir was indwelt in the hepatic artery from the left subclavian artery to administer WHF at a dose of 5-FU of 1000mg/body/week. It took 5 hours for one regimen. After starting the WHF regimen. CA19-9 decreased gradually, and after the 15th regimen the hepatic metastasis completely disappeared on CT and US. The effect of the regimen was rated as CR. Since then, the patient had severe diarrhea after additional third WHF regimen, so that the regimen was discontinued. There has been no recurrence of hepatic metastasis on CT as of about 9 months after CR was achieved, and the patient is alive in PSO.