title: [A Case of Radical Resection for Locally Advanced Pancreatic Cancer with Positive Peritoneal Cytology Treated with Chemoradiotherapy].
abstract: A 54-year-old female patient was admitted with obstructive jaundice. The patient was diagnosed with locally advanced unresectable pancreatic cancer of the head with invasion to the super mesenteric artery and the third portion of the duodenum. A biliary- and gastric-enteric bypass surgery was performed, and peritoneal lavage cytology was positive during surgery. After 6 courses of gemcitabine and S-1 combination chemotherapy, the CA19-9 level was normalized and the primary tumor shrank to 79% of its original size. Diagnostic laparoscopy revealed that distant metastasis was not detected and the peritoneal lavage cytology was negative. After additional chemoradiation therapy, a pancreaticoduodenectomy was perfomed. Microscopic investigation revealed that about 60% of the cancer tissue had been replaced by fibrosis and no cancer cells were found at the surgical margin. The patient was alive with no evidence of recurrence 17 months after radical surgery.
authors.affiliation: Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences.
authors.forename: Ryohei
authors.initials: R
authors.lastname: Sato
authors.forename: Kazuyasu
authors.initials: K
authors.lastname: Takizawa
authors.forename: Kizuki
authors.initials: K
authors.lastname: Yuza
authors.forename: Daiki
authors.initials: D
authors.lastname: Soma
authors.forename: Yuki
authors.initials: Y
authors.lastname: Hirose
authors.forename: Yuta
authors.initials: Y
authors.lastname: Morimoto
authors.forename: Kohei
authors.initials: K
authors.lastname: Miura
authors.forename: Masayuki
authors.initials: M
authors.lastname: Nagahashi
authors.forename: Kabuto
authors.initials: K
authors.lastname: Takano
authors.forename: Jun
authors.initials: J
authors.lastname: Sakata
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Kameyama
authors.forename: Takashi
authors.initials: T
authors.lastname: Kobayashi
authors.forename: Masahiro
authors.initials: M
authors.lastname: Minagawa
authors.forename: Shin-ichi
authors.initials: S
authors.lastname: Kosugi
authors.forename: Toshifumi
authors.initials: T
authors.lastname: Wakai
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D059248:Chemoradiotherapy; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D004338:Drug Combinations; D005260:Female; D006801:Humans; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D010094:Oxonic Acid / Q000008:administration & dosage; D010190:Pancreatic Neoplasms / Q000473:pathology / Q000628:therapy*; D016577:Pancreaticoduodenectomy; D005641:Tegafur / Q000008:administration & dosage; D000093542:Gemcitabine
chemical_list: D004338:Drug Combinations; D003841:Deoxycytidine; C079198:S 1 (combination); D005641:Tegafur; D010094:Oxonic Acid; D000093542:Gemcitabine