title: Metachronous double cancer after curative resection for pancreatic adenocarcinoma: report of four cases.
abstract: We experienced four cases of metachronous double cancer after curative resection for pancreatic adenocarcinoma without the background of intraductal papillary mucinous neoplasm. Case 1, a 67-year-old Japanese female developed tongue cancer 53 months after a pylorus-preserving Whipple resection for pancreatic head adenocarcinoma. Case 2, a 66-year-old female developed multiple breast cancers 52 months after a pylorus-preserving pancreaticoduodenectomy for pancreatic head adenocarcinoma. Case 3, a 59-year-old male developed an adenocarcinoma in the remnant pancreatic head 63 months after a distal pancreatectomy for pancreatic body cancer. Case 4, a 68-year-old male developed lung cancer 92 months after a Whipple procedure for pancreatic head adenocarcinoma. Gemcitabine was administered to three patients as adjuvant chemotherapy at an average administrated dose of 38,199 mg per body surface area. Since primary pancreatic ductal adenocarcinoma is aggressive and always associated with a devastating outcome, metachronous double cancer is scarcely seen. All four cases received curative-intent surgery for each metachronous cancer and were alive for at least 20 months.
authors.affiliation: Department of Surgery, Hamamatsu Medical Center, 328 Tomitsuka, Hamamatsu, Shizuoka, 432-8580, Japan. yikemats@hmedc.or.jp.
authors.forename: Yoshito
authors.initials: Y
authors.lastname: Ikematsu
authors.affiliation: Department of Surgery, Hamamatsu Medical Center, 328 Tomitsuka, Hamamatsu, Shizuoka, 432-8580, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Tamura
authors.affiliation: Department of Surgery, Hamamatsu Medical Center, 328 Tomitsuka, Hamamatsu, Shizuoka, 432-8580, Japan.
authors.forename: Tadataka
authors.initials: T
authors.lastname: Hayashi
authors.affiliation: Department of Breast Surgery, Hamamatsu Medical Center, Hamamatsu, Japan.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Tokunaga
authors.affiliation: Department of Otorhinolaryngology, Hamamatsu Medical Center, Hamamatsu, Japan.
authors.forename: Yuki
authors.initials: Y
authors.lastname: Misawa
authors.affiliation: Department of Pathology, Hamamatsu Medical Center, Hamamatsu, Japan.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Mori
authors.affiliation: Department of Radiology, Hamamatsu Medical Center, Hamamatsu, Japan.
authors.forename: Shinichi
authors.initials: S
authors.lastname: Hasegawa
authors.affiliation: Department of Radiology, Hamamatsu Medical Center, Hamamatsu, Japan.
authors.forename: Taketoshi
authors.initials: T
authors.lastname: Okawada
authors.affiliation: Department of Pathology, Hamamatsu Medical Center, Hamamatsu, Japan.
authors.forename: Takachika
authors.initials: T
authors.lastname: Ozawa
authors.affiliation: Department of Thoracic Surgery, Hamamatsu Medical Center, Hamamatsu, Japan.
authors.forename: Shigeru
authors.initials: S
authors.lastname: Momiki
authors.affiliation: Department of Surgery, Hamamatsu Medical Center, 328 Tomitsuka, Hamamatsu, Shizuoka, 432-8580, Japan.
authors.forename: Yoshiro
authors.initials: Y
authors.lastname: Nishiwaki
keywords: Gemcitabine; Metachronous cancer; Pancreas cancer