title: [A case of successful R0 resection after neoadjuvant therapy for locally advanced unresectable pancreatic cancer].
abstract: Adjuvant surgery for initially unresectable pancreatic cancer with a favorable response to chemotherapy or chemoradiation therapy often contributes to a better prognosis than non-surgical treatment alone. We encountered a sexagenarian woman with cancer of the pancreatic body involving the celiac trunk, common hepatic artery, and gastroduodenal artery, which are normally indicative of an unresectable tumor. After systemic chemotherapy (gemcitabine plus S-1 following chemoradiation therapy [S-1 plus irradiation, total 56 Gy]), the level of carbohydrate antigen 19-9 (CA19-9) decreased to within the normal range and the radiological findings showed a slight regression of the tumor without evidence of metastases. Ten months after the initial treatment, distal pancreatectomy with celiac axis resection was performed. Histopathologically, the tumor was almost replaced by marked fibrosis, including the nerve plexus around the adjacent arteries. Viable cells were observed in a part of the nerve plexus of the common hepatic artery alone. S-1 was administered after the surgery, and the patient has survived without recurrence for 17 months since the initial therapy. Here, we report a case of successful R0 resection after chemoradiation therapy for locally advanced unresectable pancreatic cancer.
authors.affiliation: Division of Digestive Surgery, Dept. of Surgery, Tohoku University Graduate School of Medicine.
authors.forename: Shuichi
authors.initials: S
authors.lastname: Aoki
authors.forename: Masamichi
authors.initials: M
authors.lastname: Mizuma
authors.forename: Fuyuhiko
authors.initials: F
authors.lastname: Motoi
authors.forename: Koji
authors.initials: K
authors.lastname: Fukase
authors.forename: Naoaki
authors.initials: N
authors.lastname: Sakata
authors.forename: Kei
authors.initials: K
authors.lastname: Nakagawa
authors.forename: Takaho
authors.initials: T
authors.lastname: Okada
authors.forename: Hiroki
authors.initials: H
authors.lastname: Hayashi
authors.forename: Takanori
authors.initials: T
authors.lastname: Morikawa
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yoshida
authors.forename: Takeshi
authors.initials: T
authors.lastname: Naitoh
authors.forename: Yu
authors.initials: Y
authors.lastname: Katayose
authors.forename: Shinichi
authors.initials: S
authors.lastname: Egawa
authors.forename: Michiaki
authors.initials: M
authors.lastname: Unno
mesh_terms: D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage; D059248:Chemoradiotherapy; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D004338:Drug Combinations; D005260:Female; D006801:Humans; D020360:Neoadjuvant Therapy; D010094:Oxonic Acid / Q000008:administration & dosage; D010190:Pancreatic Neoplasms / Q000628:therapy*; D005641:Tegafur / Q000008:administration & dosage; D016896:Treatment Outcome; D000093542:Gemcitabine
chemical_list: D000964:Antimetabolites, Antineoplastic; D004338:Drug Combinations; D003841:Deoxycytidine; C079198:S 1 (combination); D005641:Tegafur; D010094:Oxonic Acid; D000093542:Gemcitabine