[A resected case of effective treatment with gemcitabine for advanced pancreatic cancer with peritoneal metastasis].
We report a resected case of advanced pancreatic cancer after successful chemotherapy. A 69-year-old man with abdominal pain was diagnosed as locally advanced pancreatic tail cancer with peritoneal metastasis based on computed tomography (CT). Preoperative serum CA 19-9 was 5,046 U/mL. In the outpatient setting, gemcitabine (GEM) at a dose of 1,000 mg/m(2)was administered once a week for 3 weeks with a 1-week rest as 1 cycle. Abdominal CT scan after 5 cycles of chemotherapy revealed that ascites disappeared and the tumor dramatically shrank. Serum CA 19-9 also dropped to 12 U/mL. Thus, we considered the patient had a partial response, and performed distal pancreatectomy and splenectomy with D 3 lymph node dissection. Peritoneal seeding was not found and peritoneal washing cytology was negative. Histological examination of the primary lesion revealed a small amount of residual cancer cells. However, he died of peritoneal metastasis only 3 months after the operation. Surgical resection following chemotherapy should be performed carefully after close evaluation of the antitumor efficacy including residual isolated tumor cell for patients with previously distant metastases.
Shinchi
Hiroyuki
H
Dept. of Surgical Oncology and Digestive Surgery, Kagoshima University.
Takao
Sonshin
S
Maemura
Kosei
K
Noma
Hidetoshi
H
Mataki
Yukou
Y
Kitazono
Masaki
M
Aikou
Takashi
T
D000368:Aged; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage*; D003131:Combined Modality Therapy; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D004334:Drug Administration Schedule; D006801:Humans; D008197:Lymph Node Excision; D008297:Male; D010180:Pancreatectomy / Q000379:methods; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D010534:Peritoneal Neoplasms / Q000188:drug therapy* / Q000556:secondary*; D013156:Splenectomy; D014057:Tomography, X-Ray Computed; D000093542:Gemcitabine
D000964:Antimetabolites, Antineoplastic; D003841:Deoxycytidine; D000093542:Gemcitabine