Disease-free survival for 9 years after liver resection for stage IV gallbladder cancer: Report of a case

We report herein the case of a 66-year-old woman who has survived for more than 9 years without recurrence since undergoing a right trisegmentectomy of the liver with biliary reconstruction using the jejunum for stage IV (T1, N1a, M0, UICC) gallbladder cancer. The resected tumor, which was histologically diagnosed as moderately to poorly differentiated adenocarcinoma, was approximately 8cm in diameter and infiltrated from the gallbladder to the medial, anterior, and posterior segments of the liver, involving the right hepatic and common hepatic ducts and the right hepatic artery; no intrahepatic distant metastasis was found. Although preoperative imaging diagnosis showed swollen lymph nodes at the hepatoduodenal ligament and paraaortic region, histological analysis of the resected lymph nodes revealed only one metastasis, located at the cystic duct which was involved in the tumor. This case demonstrates that curative resection may be the appropriate surgical intervention for patients with a stage IV tumor and direct infiltration to the liver and surrounding organs but no distant metastases.