A Case of Pancreatic Head Carcinoma with Inferior Vena Cava Invasion for Which a Pathological Complete Response Was Achieved with Preoperative Chemotherapy of Gemcitabine+Nab-Paclitaxel That Enabled Radical Resection

Abstract

The patient was a 23-year-old man who was diagnosed with locally advanced cancer of the pancreatic head and associated invasion of the inferior vena cava. He was treated with four cycles of 1,000 mg/m² gemcitabine+125 mg/m² nab-paclitaxel chemotherapy, with three administrations and one rest period in each cycle. After chemotherapy, diagnostic imaging showed that the primary lesion had contracted by 41%, and pancreatic head and duodenal resection was performed, along with inferior vena cava resection. Histopathological images of resected samples showed fibrosis and inflammatory cell invasion, which were considered to be effects of chemotherapy. No viable cancer cells were visible and a complete pathological response was assumed to have been achieved. The patient was administered 120 mg/body/day S-1 orally as postoperative adjuvant chemotherapy. At 21 months after surgery, and 30 months after definitive diagnosis, the patient is currently alive without recurrence.