THREE CASES OF UNRESECTABLE BILE DUCT CANCER TREATED WITH GEMCITABINE, CISPLATIN, AND DURAVULAMAB FOLLOWED BY CONVERSION SURGERY b_ball_major@yahoo.co.jp

PE021

THREE CASES OF UNRESECTABLE BILE DUCT CANCER TREATED WITH GEMCITABINE, CISPLATIN, AND DURAVULAMAB FOLLOWED BY CONVERSION SURGERY

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Japan

Poster Exhibition only

We report the treatment outcomes of three cases of unresectable advanced biliary tract cancer who underwent conversion surgery after gemcitabine + cisplatin + durvalumab（GCD） therapy.

We retrospectively reviewed the treatment outcomes of three patients who underwent conversion surgery after GCD therapy for unresectable biliary tract cancer at our hospital between December 2022 and July 2025.

＜Case 1＞ 67-year-old female. Diagnosis: Gallbladder cancer, cT4b, cN2, cM0, cStage IVB. Surgery consisted of gallbladder bed resection. Pathological diagnosis: ypT2a, ypN0, ypM0. The histological response of Grade 3. She received six courses of durvalumab adjuvant chemotherapy. She has survived without recurrence for 30 months. A 70-year-old male. Diagnosis: Ampullary carcinoma, cT2, cN1, cM1(H), cStage IV. Surgery consisted of a pancreaticoduodenectomy. Pathological diagnosis: ypT0, ypN0, ypM0, ypStage 0. The histological response was Grade 4. Although there was a postoperative recurrence, he has survived for 34 months. A 73-year-old male. Diagnosis: Gallbladder cancer, cT3b, cN1, cM1(H), cStage IVB. Laparoscopic cholecystectomy was performed. Pathological diagnosis: ypT2b, ypN0, M0, ypStage IIB. Histological response was assessed as Grade 2. 4 courses of durvalumab were administered as adjuvant chemotherapy. There has been no postoperative recurrence and the patient is currently alive 21 months later.

Conversion surgery can be considered when factors contributing to unresectable disease are eliminated by GCD therapy. However, early recurrence may occur in patients who are unable to receive adjuvant chemotherapy after conversion surgery.