2017 Volume 32 Issue 6 Pages 891-896
A 46-year-old woman was referred to our hospital for a tumor detected in the pancreatic head. Endoscopic ultrasound-guided fine-needle aspiration yielded a diagnosis of unresectable pancreatic cancer with hepatic metastasis in the lateral segment (UR-M). After a complete response was achieved with 14 courses of FOLFIRINOX (fluorouracil, leucovorin, irinotecan, and oxaliplatin) therapy, she underwent subtotal stomach-preserving pancreaticoduodenectomy in combination with resection and reconstruction of the superior mesenteric vein, transverse colectomy, and S3 hepatic subsegmentectomy. Histopathological findings revealed replacement of the resection site tissue with a fibrous scar and the presence of only 2 atypical glands in the duodenal muscle layer. A margin-negative (R0) resection was achieved. To date, the patient has been alive without recurrence for 21 months, since treatment initiation, i.e., for 10 months after surgery. In recent years, there have been increasing reports of conversion surgery for unresectable pancreatic cancer, which is treated with radical resection after chemotherapy. Our case suggested that FOLFIRINOX therapy might permit conversion surgery for unresectable pancreatic cancer with distant metastases and improve its prognosis.
