A Case of Borderline Resectable Pancreatic Head Cancer Treated by Curative Resection after Chemotherapy
Nakayasu, Y.; Shiozawa, S.; Usui, T.; Kuhara, K.; Kono, T.; Shimojima, Y.; Tsuchiya, A.; Miyauchi, T.; Asaka, S.; Yamaguchi, K.; Yokomizo, H.; Shimakawa, T.; Naritaka, Y.
Gan to Kagaku Ryoho. Cancer and ChemoTherapy 45(13): 2306-2308
2018
ISSN/ISBN: 0385-0684 PMID: 30692446 Document Number: 696061
A 77-year-old woman with back and epigastric pains was diagnosed with pancreatic head cancer according to the result of contrast computed tomography, which showed a 25mm irregular low-density area at the pancreatic head infiltrating nearly half of the superior mesenteric plexus. There were no findings of lymph node metastasis or distant metastasis. The pretreatment diagnosis was borderline resectable(BR)pancreatic head cancer, cT3, N0, M0, cStage ⅡA. The patient was treated with gemcitabine plus nab-paclitaxel therapy. She developed Grade 3 neutropenia, and the dose was adjusted in order to continue chemotherapy. The size of the tumor had reduced to 15mm after 6 courses of the therapy, and the infiltration into the superior mesenteric plexus had also reduced. Therefore, the patient underwent subtotal stomach-preserving pancreatoduodenectomy and D2 lymph node dissection. The histopathological findings were invasive ductal carcinoma with R0 radical resection. The efficacy of preoperative adjuvant chemotherapy for BR pancreatic cancer has not been established yet, but improving the R0 resection rate with preoperative chemotherapy may contribute to an improvement in the outcome of pancreatic cancer.