{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:24:06Z","timestamp":1787027046247,"version":"build-2736575974"},"reference-count":26,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T00:00:00Z","timestamp":1767744000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:p>A 61-year-old female patient presented with a 10-day history of right upper abdominal pain and was subsequently diagnosed with stage IV gallbladder cancer based on preoperative imaging and pathological evaluation. Following multidisciplinary discussion, a triple-agent combination therapy was initiated. Although the patient developed severe grade II cutaneous toxicity during treatment, a significant clinical response was achieved, and symptoms were effectively relieved with supportive management. After four months of conversion therapy, the patient underwent successful radical surgical resection. Five months postoperatively, isolated hepatic metastases were identified, and a multidisciplinary team subsequently recommended radiofrequency ablation. The patient is currently receiving maintenance therapy with immune checkpoint inhibitors. At the most recent follow-up, the patient remains disease-free, with an overall survival of 18 months.<\/jats:p>","DOI":"10.3389\/fonc.2025.1749491","type":"journal-article","created":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T05:15:54Z","timestamp":1767762954000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Multidisciplinary management of surgery and postoperative recurrence in stage IV gallbladder cancer following conversion therapy: a case report"],"prefix":"10.3389","volume":"15","author":[{"given":"Junfeng","family":"Cheng","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuemin","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chao","family":"Ren","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shian","family":"Yu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongwei","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shishi","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianji","family":"Dai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,1,7]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1634\/theoncologist.2009-0302","article-title":"Current management of gallbladder carcinoma","volume":"15","author":"Zhu","year":"2010","journal-title":"oncol"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1007\/s12094-015-1436-2","article-title":"Biliary tract cancers: SEOM clinical guidelines","volume":"17","author":"Benavides","year":"2015","journal-title":"Clin Transl Oncol"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-199610000-00009","article-title":"Resection of nonresectable liver metastases from colorectal cancer after neoadjuvant chemotherapy","volume":"224","author":"Bismuth","year":"1996","journal-title":"Ann Surg"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-012-2312-8","article-title":"Surgical resection after downsizing chemotherapy for initially unresectable locally advanced biliary tract cancer: a retrospective single- center study","volume":"20","author":"Kato","year":"2013","journal-title":"Ann Surg Oncol"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1097\/sla.0000000000004564","article-title":"Multicenter randomized phase 2 trial comparing chemoradiotherapy and docetaxel plus 5- fluorouracil and cisplatin chemotherapy as initial induction for subsequent conversion surgery in patients with clinical T4b Esophageal Cancer: Short-term results","volume":"274","author":"Sugimura","year":"2021","journal-title":"Ann Surg"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2022.954685","article-title":"Conversion therapy from unresectable stage IIIC non-small-cell lung cancer to radical surgery via anti-PD-1 immunotherapy combined with chemotherapy and antiangiogenesis: A case report and literature review","volume":"12","author":"Jia","year":"2022","journal-title":"Front Oncol"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0908721","article-title":"Cisplatin plus gemcitabine versus gemcitabine for biliary tract cancer","volume":"362","author":"Valle","year":"2010","journal-title":"N Engl J Med"},{"key":"B8","doi-asserted-by":"publisher","first-page":"e1240","DOI":"10.1136\/jitc-2020-001240","article-title":"Camrelizumab plus gemcitabine and oxaliplatin (GEMOX) in patients with advanced biliary tract cancer: a single-arm, open-label, phase II trial","volume":"8","author":"Chen","year":"2020","journal-title":"J Immunother Cancer"},{"key":"B9","doi-asserted-by":"publisher","first-page":"906","DOI":"10.1016\/j.jamcollsurg.2016.12.058","article-title":"Systemic chemotherapy combined with resection for locally advanced gallbladder carcinoma: surgical and survival outcomes","volume":"224","author":"Creasy","year":"2017","journal-title":"J Am Coll Surg"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1016\/j.hpb.2018.03.008","article-title":"Outcome of neoadjuvant chemotherapy in \"locally advanced\/borderline resectable\" gallbladder cancer: the need to define indications","volume":"20","author":"Chaudhari","year":"2018","journal-title":"HPB (Oxford)"},{"key":"B11","doi-asserted-by":"publisher","first-page":"30","DOI":"10.1186\/s13256-021-03248-9","article-title":"Locally advanced gallbladder cancer treated with effective chemotherapy and subsequent curative resection: a case report","volume":"16","author":"Inoue","year":"2022","journal-title":"J Med Case Rep"},{"key":"B12","doi-asserted-by":"publisher","first-page":"50","DOI":"10.1186\/s40792-022-01406-9","article-title":"Conversion surgery following gemcitabine plus cisplatin therapy for initially unresectable gallbladder cancer with peritoneal carcinomatosis: a case report","volume":"8","author":"Wakasa","year":"2022","journal-title":"Surg Case Rep"},{"key":"B13","article-title":"A case of advanced gallbladder cancer with paraaortic lymph node metastases successfully treated by chemotherapy and conversion surgery","volume":"45","author":"Tsuyuki","year":"2018","journal-title":"Gan To Kagaku Ryoho"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.5582\/bst.2020.03240","article-title":"Systemic treatment of advanced or recurrent biliary tract cancer","volume":"14","author":"Zhang","year":"2020","journal-title":"Biosci Trends"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.21873\/anticanres.14282","article-title":"Second-line treatment in advanced biliary tract cancer: today and tomorrow","volume":"40","author":"Rizzo","year":"2020","journal-title":"Anticancer Res"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.3390\/cancers13071647","article-title":"Current status and future perspectives of perioperative therapy for resectable biliary tract cancer: A multidisciplinary review","volume":"13","author":"Yoo","year":"2021","journal-title":"Cancers"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1002\/jhbp.1135","article-title":"Conversion surgery after preoperative therapy for advanced hepatocellular carcinoma in the era of molecular targeted therapy and immune checkpoint inhibitors","volume":"29","author":"Arita","year":"2022","journal-title":"J Hepatobil Pancreat Sci"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1056\/EVIDoa2200015","article-title":"Durvalumab plus gemcitabine and cisplatin in advanced biliary tract cancer","volume":"1","author":"Dy","year":"2022","journal-title":"NEJM Evid"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(23)00727-4","article-title":"Pembrolizumab in combination with gemcitabine and cisplatin compared with gemcitabine and cisplatin alone for patients with advanced biliary tract cancer (KEYNOTE-966): a randomised, double-blind, placebo-controlled, phase 3 trial","volume":"401","author":"Kelley","year":"2023","journal-title":"Lancet"},{"key":"B20","doi-asserted-by":"publisher","first-page":"106","DOI":"10.1038\/s41392-023-01317-7","article-title":"Toripalimab combined with lenvatinib and GEMOX is a promising regimen as first-line treatment for advanced intrahepatic cholangiocarcinoma: a single-center, single-arm, phase 2 study","volume":"8","author":"Shi","year":"2023","journal-title":"Signal Transduct Target Ther"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1038\/s41571-020-0413-z","article-title":"Immunostimulation with chemotherapy in the era of immune checkpoint inhibitors","volume":"17","author":"Galluzzi","year":"2020","journal-title":"Nat Rev Clin Oncol"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2008.01.001","article-title":"Chemotherapeutic agents and the skin: An update","volume":"58","author":"Heidary","year":"2008","journal-title":"J Am Acad Dermatol"},{"key":"B23","doi-asserted-by":"publisher","first-page":"95","DOI":"10.1186\/s40425-017-0300-z","article-title":"Managing toxicities associated with immune checkpoint inhibitors: consensus recommendations from the Society for Immunotherapy of Cancer (SITC) Toxicity Management Working Group","volume":"5","author":"Puzanov","year":"2017","journal-title":"J Immunother Can"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1111\/1346-8138.15654","article-title":"Characteristic distribution of maculopapular rash caused by gemcitabine-based chemotherapy","volume":"48","author":"Tohyama","year":"2021","journal-title":"J Dermatol"},{"key":"B25","doi-asserted-by":"publisher","first-page":"86","DOI":"10.3322\/caac.21596","article-title":"A review of cancer immunotherapy toxicity","volume":"70","author":"Kennedy","year":"2020","journal-title":"CA Cancer J Clin"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-020-08207-0","article-title":"Proposed definition for oligometastatic recurrence in biliary tract cancer based on results of locoregional treatment: A propensity-score-stratified analysis","volume":"27","author":"Morino","year":"2020","journal-title":"Ann Surg Oncol"}],"container-title":["Frontiers in Oncology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2025.1749491\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T05:15:56Z","timestamp":1767762956000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2025.1749491\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,7]]},"references-count":26,"alternative-id":["10.3389\/fonc.2025.1749491"],"URL":"https:\/\/doi.org\/10.3389\/fonc.2025.1749491","relation":{},"ISSN":["2234-943X"],"issn-type":[{"value":"2234-943X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,7]]},"article-number":"1749491"}}