Conversion Surgery for Unresectable Pancreatic Cancer with Para-aortic Lymph Node and Liver Metastases and Renal Infiltration—A Case Report—

Abstract

A 74-year-old man with unresectable cancer of the tail of the pancreas, para-aortic lymph node enlargement, liver metastases, and renal infiltration underwent gemcitabine plus nab-paclitaxel (GnP) therapy. After three months, the liver and lymph node metastases disappeared, and conversion surgery was planned after ten months. Preoperative renal function assessment confirmed adequate function post-left nephrectomy. The patient underwent distal pancreatectomy, partial gastrectomy, splenectomy, and left nephrectomy. Intraoperative contrast-enhanced ultrasonography confirmed the absence of liver metastases, eliminating the need for hepatectomy. Postoperatively, GnP therapy continued for six months. Two years after surgery, the patient remains recurrence-free. This case highlights successful conversion surgery following systemic therapy, emphasizing the importance of preoperative renal assessment and postoperative chemotherapy continuation.