AI Article Synopsis

  • Pancreatic cancer is considered resectable only when there are no metastases or surrounding organ involvement; in this case, a 61-year-old woman initially diagnosed with advanced pancreatic adenocarcinoma was treated with chemotherapy before surgery.
  • After receiving a combination of gemcitabine and S-1, she showed a partial response, allowing for a successful pancreaticoduodenectomy, where the majority of the tumor was replaced with fibrotic tissue and very few cancer cells remained.
  • This case indicates that a targeted preoperative chemotherapy regimen can improve surgical outcomes and potentially increase resection rates in patients with pancreatic cancer previously deemed inoperable.

Article Abstract

Pancreatic cancer is considered resectable only when there are no distant metastases or infiltration of surrounding organs or arteries. We describe a patient with primarily inoperable locally advanced pancreatic adenocarcinoma who underwent curative surgical treatment after preoperative chemotherapy. A 61-year-old woman was admitted for further evaluation of a pancreatic head mass discovered fortuitously on a health screening. Examination revealed locally advanced pancreatic cancer with infiltration of the superior mesenteric artery. After a partial response was obtained by chemotherapy with gemcitabine (GEM) and S-1, we performed pancreaticoduodenectomy. Microscopically, the main tumor was replaced with fibrotic tissue, and there were only a few residual adenocarcinoma cells in the pancreatic head. The radicality of the surgery was R0, according to the TNM classification. Our results suggest that neoadjuvant treatment with GEM/S-1 on a sustainable regimen offers the possibility of a multimodal treatment concept for all patients and a higher radical-resection rate in patients with otherwise unresectable pancreatic cancers.

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