title: [A Case of Borderline Resectable Pancreatic Cancer Responding to Preoperative GEM plus Nab-PTX Combination Chemotherapy].
abstract: We report a case of borderline resectable(BR)pancreatic cancer, which was eligible for R0 resection following preoperative chemotherapy with GEM plus nab-PTX. A 77-year-old woman presented with brown urine and clay-colored stool. After further examination, she was diagnosed with obstructive jaundice due to pancreatic head cancer. Because the tumor was in contact with the region attached to the SMA nerve plexus, she was also diagnosed with BR-A pancreatic cancer. After 6 courses of preoperative GEM plus nab-PTX combination chemotherapy, she underwent subtotal stomach-preservingpancreaticoduodenectomy with SMV resection and right semicircular SMA nerve plexus dissection. In the histopathological diagnosis, malignant cells were observed at low levels in both the pancreatic parenchyma and duodenal mucosa. There were no findings of residual malignant cells in the wall of the SMV or in the nerve plexus around the SMA. Since the final diagnosis was pT3,(DU+), pN0, cM0, fStage III , we concluded that the R0 resection as complete. Histological therapeutic evaluation with the Evans classification concluded that the disease was Grade III . GEM plus nab-PTX combination chemotherapy could be considered for preoperative chemotherapy, which may allow R0 resection for BR pancreatic cancer.
authors.affiliation: Dept. of Gastroenterological, Breast and Endocrine Surgery, Yamaguchi University Graduate School of Medicine.
authors.forename: Takuya
authors.initials: T
authors.lastname: Fujimoto
authors.forename: Tomio
authors.initials: T
authors.lastname: Ueno
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Sakamoto
authors.forename: Satoshi
authors.initials: S
authors.lastname: Matsukuma
authors.forename: Hiroto
authors.initials: H
authors.lastname: Matsui
authors.forename: Yoshitaro
authors.initials: Y
authors.lastname: Shindo
authors.forename: Yukio
authors.initials: Y
authors.lastname: Tokumitsu
authors.forename: Shinsuke
authors.initials: S
authors.lastname: Kanekiyo
authors.forename: Michihisa
authors.initials: M
authors.lastname: Iida
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Tokuhisa
authors.forename: Nobuaki
authors.initials: N
authors.lastname: Suzuki
authors.forename: Shigeru
authors.initials: S
authors.lastname: Takeda
authors.forename: Shigefumi
authors.initials: S
authors.lastname: Yoshino
authors.forename: Shoichi
authors.initials: S
authors.lastname: Hazama
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Nagano
mesh_terms: D000368:Aged; D000418:Albumins / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D005260:Female; D006801:Humans; D020360:Neoadjuvant Therapy; D017239:Paclitaxel / Q000008:administration & dosage; D010190:Pancreatic Neoplasms / Q000188:drug therapy* / Q000601:surgery; D016896:Treatment Outcome; D000093542:Gemcitabine
chemical_list: C520255:130-nm albumin-bound paclitaxel; D000418:Albumins; D003841:Deoxycytidine; D017239:Paclitaxel; D000093542:Gemcitabine