Terao Hikaru, Maruyama Tomohiro, Aono Takashi, Suzuki Susumu, Kaneko Kazuhiro, Sato Tomoi, Okada Takayuki, Muto Ichiro, Hasegawa Masaki, Muneoka Yusuke, Tajima Yosuke, Ichikawa Hiroshi, Shimada Yoshifumi, Sakata Jun, Wakai Toshifumi
Dept. of Surgery, Niigata Prefectural Central Hospital.
Gan To Kagaku Ryoho. 2023 Dec;50(13):1569-1571.
A 72-year-old woman presented with obstructive jaundice. Computed tomography revealed a 12-mm low-density mass in the head of the pancreas. She was diagnosed as having pancreatic cancer by endoscopic ultrasound-guided fine-needle aspiration. She received gemcitabine plus nab-paclitaxel as preoperative chemotherapy. After 2 courses, hepatoduodenal lymph node metastasis appeared and was accompanied by increased tumor marker levels. The regimen was changed to modified FOLFIRINOX. After 5 courses, the lymph node metastasis was reduced in size and the tumor marker levels were decreased, so subtotal stomach-preserving pancreaticoduodenectomy was performed. Adjuvant chemotherapy was administered postoperatively. The patient was alive and well without recurrence 2 years and 9 months after the surgery, but died of sepsis. Nevertheless, this case highlights that when preoperative chemotherapy for resectable pancreatic cancer appears to be ineffective, a change in regimen may be useful.
