Fujisaki Shigeru, Takashina Motoi, Tomita Ryouichi, Sakurai Kenichi, Takayama Tadatoshi, Okamura Yukiyasu
Dept. of Surgery, Fujisaki Hospital.
Gan To Kagaku Ryoho. 2022 Dec;49(13):1568-1569.
Postoperative recurrence of invasive pancreatic ductal carcinoma(PC)has a poor prognosis. We experienced a case of PC that relapsed 17 months after pancreaticoduodenectomy(PD)and survived for more than 10 years after PD. A 51-year-old man underwent PD in December 2011(pT3pN1bM0, pStage Ⅱb). Gemcitabine(GEM)16 cycles were performed as postoperative adjuvant chemotherapy, and a 1 cm nodule was found in the liver on abdominal CT scan, and partial liver resection was performed. After that, adjuvant chemotherapy with S-1 was performed for 12 months. Abdominal CT scan revealed abdominal lymph node metastasis, and radiation therapy(39.6 Gy)was requested from another hospital. Then, the combination therapy of 5-FU/l-LV plus L-OHP(or CPT-11)was started in September 2014. To date, a total of 131 cycles of chemotherapy have been given. 10 years and 5 months after pancreaticoduodenectomy and 9 years after hepatectomy, although recurrence around the superior mesenteric artery plexus was observed, outpatient visits are continued.
侵袭性胰腺导管癌(PC)术后复发预后较差。我们遇到一例PC患者,在胰十二指肠切除术(PD)后17个月复发,且在PD后存活超过10年。一名51岁男性于2011年12月接受了PD手术(pT3pN1bM0,pⅡb期)。术后进行了16周期的吉西他滨(GEM)辅助化疗,腹部CT扫描发现肝脏有一个1 cm的结节,遂行部分肝切除术。此后,进行了12个月的S-1辅助化疗。腹部CT扫描显示腹部淋巴结转移,遂转至另一家医院接受放射治疗(39.6 Gy)。然后,于2014年9月开始5-FU/亚叶酸钙联合奥沙利铂(或伊立替康)的联合治疗。迄今为止,共进行了131周期的化疗。在胰十二指肠切除术后10年零5个月以及肝切除术后9年,尽管观察到肠系膜上动脉丛周围复发,但患者仍继续门诊随访。