Akaishi Takanobu, Ishido Keinosuke, Kimura Norihisa, Nagase Hayato, Odagiri Tadashi, Fujita Hiroaki, Chen Yu, Saito Kensuke, Takahata Takenori, Sato Atsushi, Hakamada Kenichi
Dept. of Gastroenterological Surgery, Hirosaki University Graduate School of Medicine.
Gan To Kagaku Ryoho. 2019 Dec;46(13):2551-2553.
A 50-year-old woman was diagnosed as having pancreatic head cancer with multiple hepatic metastases. FOLFIRINOX therapy was initiated. After completing 18 courses of therapy, partial remission(PR)was achieved based on images, and surgery was then planed. The subtotal stomach-preserving pancreaticoduodenectomy and hepatic S7 partial resection were performed. Macroscopically, complete resection was achieved. Regarding pathological findings of the primary lesion and hepatic metastatic lesions, fibrous formation and hyalinizing condition induced by chemotherapy were noted; moreover, complete disappearance of cancer cells was detected. However, metastasis of poorly differentiated adenocarcinoma was detected in 12b lymph node tissue. One month after the surgery, postoperative adjunctive chemotherapy with S-1 was initiated. However, new hepatic metastasis was detected 3 months after the surgery. Although recurrence treatment was initiated, the disease progressed, and the patient died 11 months after the surgery.
一名50岁女性被诊断为胰头癌伴多发肝转移。开始采用FOLFIRINOX方案治疗。完成18个疗程的治疗后,根据影像学检查达到部分缓解(PR),随后计划进行手术。实施了保留胃的胰十二指肠次全切除术和肝S7部分切除术。肉眼可见实现了完整切除。关于原发灶和肝转移灶的病理检查结果,注意到化疗诱导的纤维形成和玻璃样变情况;此外,检测到癌细胞完全消失。然而,在12b淋巴结组织中检测到低分化腺癌转移。术后1个月开始使用S-1进行术后辅助化疗。然而,术后3个月检测到新的肝转移。尽管开始了复发治疗,但疾病仍进展,患者在术后11个月死亡。