内容紹介
A Case of Stage Ⅳb Pancreatic Head Cancer That Was Resected because of a Good Response to Chemotherapy
Summary
The prognosis of Stage Ⅳb pancreatic cancer is extremely poor; the mean survival time is 2-4 months. However, new anticancer agents can improve the outcome of advanced pancreatic cancer. We present the case of a 50-year-old female patient with Stage Ⅳb pancreatic head cancer with invasion to the superior mesenteric vein(SMV)and multiple liver metastases. The patient received S-1 as first-line chemotherapy. Three months later, a further CT scan showed reduction of the pancreatic tumor, disappearance of the liver metastases, and reduction in SMV invasion. Therefore, a subtotal stomach-preserving pancreatoduodenectomy with partial SMV resection was performed. Following surgery, the patient received S-1 chemotherapy again. However, lung metastasis appeared. Despite the initiation of gemcitabine(GEM)treatment, the patient developed metastases in other parts of the lung and the abdominal wall. She died 46 months after surgery, but it is noteworthy that the liver metastases were manageable. The combination of chemotherapy and surgery was effective in prolonging survival in this patient with Stage Ⅳb pancreatic head cancer.
要旨
症例は50歳,女性。上腸間膜静脈浸潤および多発性肝転移を疑うStage Ⅳb膵頭部癌に対しS-1による化学療法を施行したところ,3か月後に上腸間膜静脈浸潤は軽減,肝腫瘤は消失,切除可能と判断し上腸間膜静脈合併切除を伴う亜全胃温存膵頭十二指腸切除術を施行した。術後S-1による化学療法を継続するも肺転移が出現し術後46か月目に原病死したが,化学療法が奏効後に切除を行うことにより,Stage Ⅳb膵頭部癌にもかかわらず長期生存が得られた。
目次
Summary
The prognosis of Stage Ⅳb pancreatic cancer is extremely poor; the mean survival time is 2-4 months. However, new anticancer agents can improve the outcome of advanced pancreatic cancer. We present the case of a 50-year-old female patient with Stage Ⅳb pancreatic head cancer with invasion to the superior mesenteric vein(SMV)and multiple liver metastases. The patient received S-1 as first-line chemotherapy. Three months later, a further CT scan showed reduction of the pancreatic tumor, disappearance of the liver metastases, and reduction in SMV invasion. Therefore, a subtotal stomach-preserving pancreatoduodenectomy with partial SMV resection was performed. Following surgery, the patient received S-1 chemotherapy again. However, lung metastasis appeared. Despite the initiation of gemcitabine(GEM)treatment, the patient developed metastases in other parts of the lung and the abdominal wall. She died 46 months after surgery, but it is noteworthy that the liver metastases were manageable. The combination of chemotherapy and surgery was effective in prolonging survival in this patient with Stage Ⅳb pancreatic head cancer.
要旨
症例は50歳,女性。上腸間膜静脈浸潤および多発性肝転移を疑うStage Ⅳb膵頭部癌に対しS-1による化学療法を施行したところ,3か月後に上腸間膜静脈浸潤は軽減,肝腫瘤は消失,切除可能と判断し上腸間膜静脈合併切除を伴う亜全胃温存膵頭十二指腸切除術を施行した。術後S-1による化学療法を継続するも肺転移が出現し術後46か月目に原病死したが,化学療法が奏効後に切除を行うことにより,Stage Ⅳb膵頭部癌にもかかわらず長期生存が得られた。