Abstract
We report a resected case of advanced pancreatic head cancer with para-aortic lymph node metastases after successful gemcitabine (GEM)+S-1 chemotherapy. A 66-year-old woman with back pain was found to have pancreatic head cancer with para-aortic lymph node metastases, based on CT and FDG-PET. We gave 1,000 mg/body GEM on days 1 and 8, and S-1 was administered orally at 80 mg/day for two weeks, followed by a 1-week recovery period. After 3 cycles of chemotherapy, there was a notable reduction in para-aortic lymph node size, and FDG-PET showed a negative response. Thus, after the addition of 1 cycle of chemotherapy, we performed a pylorus-preserving pancreaticoduodenectomy with para-aortic lymph node dissection. Histologically, cancer cells in para-aortic lymph nodes were absent. We performed an R0 resection. Currently, at 13 months after surgery, the patient is in good health without recurrence. GEM+S-1 chemotherapy for unresectable pancreatic cancer is considered to be one of the options in cases that are expected to convert to the resection.
