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Multidisciplinary Treatment of Hilar Cholangiocarcinoma in a Patient with Complicated New-Onset Coronary Artery Disease
Annals of Oncology 25 (Supplement 5): v75–v109, 2014 doi:10.1093/annonc/mdu436.88
Poster Session (Poster presentations categorized by each organ) P2
12
3
Takahisa Fujikawa, Yasunori Yoshimoto, Akira Tanaka Department of Surgery, Kokura Memorial Hospital
abstracts
Introduction: In non-cardiac surgery patients receiving antiplatelet therapy, especially in patients with recent coronary stent implantation, perioperative management is challenging due to increased risks of perioperative bleeding or thromboembolic
Downloaded from https://academic.oup.com/annonc/article-abstract/25/suppl_5/v94/2240535 by guest on 25 October 2019
MULTIDISCIPLINARY TREATMENT OF HILAR CHOLANGIOCARCINOMA IN A PATIENT WITH COMPLICATED NEW-ONSET CORONARY ARTERY DISEASE
complications. We have to balance both perioperative risk and oncological risk/benefit to make a decision. Case Report: We report a 69-year-old man suffering hilar cholangiocarcinoma and concurrent new-onset complicated coronary artery disease. After implanting non-drug-eluting coronary stents, combination chemotherapy with gemcitabine and S-1 under continuation of dual antiplatelet therapy was carried out and partial tumor response was achieved. Subsequently, extended right hepatectomy was performed while continuing preoperative single antiplatelet therapy with aspirin, and the patient recovered well without any thromboembolic or bleeding complications. He developed carcinomatous pleurisy 20 months after the operation, and combination chemotherapy with cisplatin and gemcitabine was introduced and continued. He remained doing well with stable cancer condition 36 months after the original diagnosis was made. Conclusion: Like the current case, neoadjuvant chemotherapy and subsequent curative resection under continuation of antiplatelet therapy, followed by preceding coronary intervention, is one of the preferred options for the treatment of hepatobiliary malignancy in patients with concurrent new-onset coronary artery disease.
© The Author 2014. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: [email protected].
Poster Session (Poster presentations categorized by each organ) P2
12
3
Takahisa Fujikawa, Yasunori Yoshimoto, Akira Tanaka Department of Surgery, Kokura Memorial Hospital
abstracts
Introduction: In non-cardiac surgery patients receiving antiplatelet therapy, especially in patients with recent coronary stent implantation, perioperative management is challenging due to increased risks of perioperative bleeding or thromboembolic
Downloaded from https://academic.oup.com/annonc/article-abstract/25/suppl_5/v94/2240535 by guest on 25 October 2019
MULTIDISCIPLINARY TREATMENT OF HILAR CHOLANGIOCARCINOMA IN A PATIENT WITH COMPLICATED NEW-ONSET CORONARY ARTERY DISEASE
complications. We have to balance both perioperative risk and oncological risk/benefit to make a decision. Case Report: We report a 69-year-old man suffering hilar cholangiocarcinoma and concurrent new-onset complicated coronary artery disease. After implanting non-drug-eluting coronary stents, combination chemotherapy with gemcitabine and S-1 under continuation of dual antiplatelet therapy was carried out and partial tumor response was achieved. Subsequently, extended right hepatectomy was performed while continuing preoperative single antiplatelet therapy with aspirin, and the patient recovered well without any thromboembolic or bleeding complications. He developed carcinomatous pleurisy 20 months after the operation, and combination chemotherapy with cisplatin and gemcitabine was introduced and continued. He remained doing well with stable cancer condition 36 months after the original diagnosis was made. Conclusion: Like the current case, neoadjuvant chemotherapy and subsequent curative resection under continuation of antiplatelet therapy, followed by preceding coronary intervention, is one of the preferred options for the treatment of hepatobiliary malignancy in patients with concurrent new-onset coronary artery disease.
© The Author 2014. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: [email protected].