title: [A case of stage IV b pancreatic head cancer that was resected because of a good response to chemotherapy].
abstract: The prognosis of Stage IV b pancreatic cancer is extremely poor; the mean survival time is 2-4 months. However, new anticancer agents can improve the outcome of advanced pancreatic cancer. We present the case of a 50-year-old female patient with Stage IV b pancreatic head cancer with invasion to the superior mesenteric vein(SMV)and multiple liver metastases. The patient received S-1 as first-line chemotherapy. Three months later, a further CT scan showed reduction of the pancreatic tumor, disappearance of the liver metastases, and reduction in SMV invasion. Therefore, a subtotal stomach-preserving pancreatoduodenectomy with partial SMV resection was performed. Following surgery, the patient received S-1 chemotherapy again. However, lung metastasis appeared. Despite the initiation of gemcitabine(GEM)treatment, the patient developed metastases in other parts of the lung and the abdominal wall. She died 46 months after surgery, but it is noteworthy that the liver metastases were manageable. The combination of chemotherapy and surgery was effective in prolonging survival in this patient with Stage IV b pancreatic head cancer.
authors.affiliation: Dept. of Gastroenterological Surgery, Hyogo Cancer Center.
authors.forename: Tadayuki
authors.initials: T
authors.lastname: Ohara
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Fujino
authors.forename: Hironobu
authors.initials: H
authors.lastname: Goto
authors.forename: Hironari
authors.initials: H
authors.lastname: Yamashita
authors.forename: Masato
authors.initials: M
authors.lastname: Oyama
authors.forename: Morihiro
authors.initials: M
authors.lastname: Katsura
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Sugiyama
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Ueda
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Hasegawa
authors.forename: Takashi
authors.initials: T
authors.lastname: Yasuda
authors.forename: Keitaro
authors.initials: K
authors.lastname: Kakinoki
authors.forename: Taro
authors.initials: T
authors.lastname: Oshikiri
authors.forename: Hiroyoshi
authors.initials: H
authors.lastname: Sendo
authors.forename: Takemi
authors.initials: T
authors.lastname: Sugimoto
authors.forename: Masahiro
authors.initials: M
authors.lastname: Tominaga
mesh_terms: D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use*; D003841:Deoxycytidine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D004338:Drug Combinations; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000556:secondary; D008175:Lung Neoplasms / Q000556:secondary; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D010094:Oxonic Acid / Q000627:therapeutic use*; D010190:Pancreatic Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D016577:Pancreaticoduodenectomy; D005641:Tegafur / Q000627:therapeutic use*; D000093542:Gemcitabine
chemical_list: D000964:Antimetabolites, Antineoplastic; D004338:Drug Combinations; D003841:Deoxycytidine; C079198:S 1 (combination); D005641:Tegafur; D010094:Oxonic Acid; D000093542:Gemcitabine