Long-Term Survival after Locally Advanced Pancreatic Ductal Adenocarcinoma Treated with Multidisciplinary Therapy - A Case Report

Goro Ueno, Daisaku Yamada, Hidetoshi Eguchi, Tadafumi Asaoka, Takehiro Noda, Hiroshi Wada, Koichi Kawamoto, Kunihito Goto, Masaki Mori, Yuichiro Doki

Research output: Contribution to journalArticle

Abstract

A 60-year-old man visited a hospital with concerns about his physical health, including weight loss, thirst, and polyuria. He was diagnosed with acute onset of diabetes, and a pancreatic head tumor was observed on imaging studies. Computed tomography(CT)indicated that the tumor infiltrated the surrounding major vessels, portal vein(PV, 360 degrees), and superior mesenteric artery(SMA, <180 degrees). Endoscopic ultrasound-guided fine needle aspiration(EUS-FNA)was performed, and he was diagnosed with a borderline resectable(BR)clinical Stage IV a pancreatic ductal adenocarcinoma (PDAC). Chemoradiation therapy(CRT, S-1 plus gemcitabine [GEM] concurrent with 50.4 Gy radiation)followed by chemotherapy( GEM)was performed until a tumor response indicating sufficient reduction of SMA infiltration was observed on imaging studies. Twelve months after initiation of treatment, a pancreaticoduodenectomy and PV resection/reconstruction were performed. The pathological stage was ypT3N0M0(ypStage III ), and SMA infiltration was not detected in the resected specimen. He was discharged after an uneventful course following surgery, and adjuvant S-1 chemotherapy was continued from post-operative day 67 for 4 months. Now at post-operative 57 month, he has survived without recurrence. There have been some reports detailing long-term survival of patients with BR tumors who underwent multidisciplinary therapy as curative resection following preoperative CRT and postoperative adjuvant chemotherapy. During preoperative treatment, it is important to monitor the effects and determine the suitable timing to perform surgery to achieve long-term survival.

Original languageEnglish
Pages (from-to)1668-1670
Number of pages3
JournalGan to kagaku ryoho. Cancer & chemotherapy
Volume43
Issue number12
Publication statusPublished - Nov 1 2016

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gemcitabine
Adenocarcinoma
Survival
Neoplasms
Endoscopic Ultrasound-Guided Fine Needle Aspiration
Thirst
Radiation Dosage
Drug Therapy
Polyuria
Pancreaticoduodenectomy
Superior Mesenteric Artery
Therapeutics
Adjuvant Chemotherapy
Portal Vein
Weight Loss
Tomography
Recurrence
Health

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

Cite this

Long-Term Survival after Locally Advanced Pancreatic Ductal Adenocarcinoma Treated with Multidisciplinary Therapy - A Case Report. / Ueno, Goro; Yamada, Daisaku; Eguchi, Hidetoshi; Asaoka, Tadafumi; Noda, Takehiro; Wada, Hiroshi; Kawamoto, Koichi; Goto, Kunihito; Mori, Masaki; Doki, Yuichiro.

In: Gan to kagaku ryoho. Cancer & chemotherapy, Vol. 43, No. 12, 01.11.2016, p. 1668-1670.

Research output: Contribution to journalArticle

Ueno, G, Yamada, D, Eguchi, H, Asaoka, T, Noda, T, Wada, H, Kawamoto, K, Goto, K, Mori, M & Doki, Y 2016, 'Long-Term Survival after Locally Advanced Pancreatic Ductal Adenocarcinoma Treated with Multidisciplinary Therapy - A Case Report', Gan to kagaku ryoho. Cancer & chemotherapy, vol. 43, no. 12, pp. 1668-1670.
Ueno, Goro ; Yamada, Daisaku ; Eguchi, Hidetoshi ; Asaoka, Tadafumi ; Noda, Takehiro ; Wada, Hiroshi ; Kawamoto, Koichi ; Goto, Kunihito ; Mori, Masaki ; Doki, Yuichiro. / Long-Term Survival after Locally Advanced Pancreatic Ductal Adenocarcinoma Treated with Multidisciplinary Therapy - A Case Report. In: Gan to kagaku ryoho. Cancer & chemotherapy. 2016 ; Vol. 43, No. 12. pp. 1668-1670.
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