A Case Report of Curative Surgery for Pancreatic Ductal Adenocarcinoma with Peritoneal Dissemination after Gemcitabine Chemotherapy

A 70-year-old man was diagnosed with pancreatic ductal adenocarcinoma(PDAC)with peritoneal dissemination and received systemic chemotherapy of gemcitabine(GEM)plus nab-paclitaxel. Since the patient could not continue the regimen due to an adverse event of liver dysfunction, he was administered GEM alone except for the first administration. GEM monotherapy resulted in remarkable anti-tumor effects with a distinct decrease of both tumor markers and size. Peritoneal metastases were not detected in images after 12 courses of the GEM regimen, and the vanished tumor metastasis in images was maintained until 16 courses were administered. After the laparoscopic examination proved no peritoneal metastasis, we performed curative surgery. The presence of peritoneal metastasis of PDAC indicated that it was at a lethal stage; however, a few cases were reported as receiving curative surgery after chemotherapy with modest long-term survival. We herein report a rare case of curative surgery following chemotherapy with GEM alone for unresectable PDAC accompanied with peritoneal dissemination.