Suzuki Susumu, Aono Takashi, Maruyama Tomohiro, Naruse Kana, Utsumi Shiori, Toge Koji, Kaneko Kazuhiro, Sato Tomoi, Okada Takayuki, Muto Ichiro, Hasegawa Masaki
Dept. of Surgery, Niigata Prefectural Central Hospital.
Gan To Kagaku Ryoho. 2022 Dec;49(13):1500-1502.
We present the case of a 47-year-old man who underwent a subtotal stomach-preserving pancreaticoduodenectomy for pancreatic head cancer. Histopathological diagnosis revealed that the majority of the cancer was an invasive micropapillary carcinoma(IMPC). Postoperative adjuvant chemotherapy using S-1 was continued for 4 years, at the end of which, multiple lymph node metastases were identified. Therefore, gemcitabine plus S-1 therapy was initiated. The treatment reduced the lymph node in size and resulted in the maintenance of a partial response for a year and a half. However, increased lymph node metastases recurred, and multiple lung metastases were noted. The patient died 7 years and 2 months after the resection of the primary lesion. Although pancreatic IMPC has a poor prognosis, long-term survival may be achieved by resection of the primary region, the administration of adjuvant chemotherapy and management of recurrent lesions by chemotherapy.
我们报告了一例47岁男性患者,其因胰头癌接受了保留大部分胃的胰十二指肠切除术。组织病理学诊断显示,大部分癌症为浸润性微乳头状癌(IMPC)。使用S-1进行术后辅助化疗持续了4年,在此化疗结束时,发现了多处淋巴结转移。因此,开始了吉西他滨联合S-1治疗。该治疗使淋巴结缩小,并维持了一年半的部分缓解。然而,淋巴结转移复发且增多,并发现了多处肺转移。患者在原发灶切除后7年2个月死亡。尽管胰腺IMPC预后较差,但通过切除原发部位、给予辅助化疗以及通过化疗处理复发病变,可能实现长期生存。