A Case of Pathological Complete Response after Neoadjuvant Chemotherapy for Borderline Resectable Pancreatic Body Cancer

Abstract

A 74-year-old man with borderline resectable pancreatic cancer was referred to our hospital. Enhanced computed tomography showed a 45-mm mass in the pancreatic body that invaded the celiac axis, splenic artery, and splenic vein.

Poorly to moderately differentiated adenocarcinoma was pathologically diagnosed by endoscopic ultrasound-guided fine needle aspiration. Distal pancreatectomy with celiac axis resection was performed after neoadjuvant chemotherapy using gemcitabine and nab-paclitaxel followed by S-1. Despite the preoperative diagnosis as partial response, the histopathological findings showed fibrous changes with an Evans classification of grade 4, which meant pathological complete response. The patient has been alive without recurrence for 18 months after R0 surgery.