%0 Journal Article
%T A patient with cholangiocarcinoma demonstrating pathologic complete response to chemotherapy: exploring the role of neoadjuvant therapy in biliary tract cancer
%A Andrew H. Ko
%A Eric K. Nakakura
%A Evan J. Walker
%A Jeffry P. Simko
%J SCIE-indexed Journal
%D 2014
%X Cholangiocarcinoma (CCA), which is traditionally thought to arise from the cholangiocytes of the epithelial bile ducts anywhere along the intra- or extra-hepatic biliary tree, remains a relatively rare cancer, comprising approximately 3% of all gastrointestinal malignancies (1,2). However, the incidence of CCA appears to be on the rise in Western populations, particularly intrahepatic CCA, where mortality also appears to be increasing (3-5). Early stage CCA can be cured in some instances with surgical resection, but the majority of patients are diagnosed when the cancer is unresectable due to local extent of the tumor (i.e., involvement of adjacent blood vessels or extension into both hepatic lobes beyond the secondary radicals), or from metastatic dissemination (6). A number of patients may also present with marginally resectable tumors; however, incomplete resections (R1/R2), even with the addition of postoperative chemotherapy and/or radiation, result in outcomes comparable to those of individuals not undergoing surgical resection (7,8). Such patients may be candidates for neoadjuvant therapy to increase the likelihood of R0 resection, but this strategy of delivering preoperative treatment for either localized or locally advanced CCA has not been studied extensively and does not currently represent an accepted standard of care. We present here the case of a patient with localized extrahepatic CCA in whom surgical resection was delayed secondary to a concurrent diagnosis of non-small cell lung cancer (NSCLC), who ultimately achieved a complete pathologic response of the CCA from gemcitabine-based chemotherapy alone
%U http://jgo.amegroups.com/article/view/2910/html