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A successful case of locally advanced pancreatic cancer undergoing curative distal pancreatectomy with en bloc celiac axis resection after combination chemotherapy of nab-paclitaxel with gemcitabine

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Abstract

Pancreatic cancer patients have a poor prognosis because of a low rate of resection that results from distant metastases or local advancement. We report a successful case of unresectable locally advanced pancreatic cancer in a patient who was curatively resected after combination therapy with nab-paclitaxel (nab-PTX) and gemcitabine (GEM). A 61-year-old man was referred for treatment of a 45-mm pancreatic tail tumor involving the celiac axis, common hepatic artery, and splenic artery that appeared as an abnormal soft-density mass on imaging. This patient’s tumor was defined as unresectable due to local advancement, and, therefore, the powerful combined chemotherapy regimen of nab-PTX with GEM was initiated to allow for possible resection later. After three cycles of chemotherapy, a CT scan revealed that the soft-density mass around the celiac axis and common hepatic artery had dramatically disappeared, and the tumor was then determined to be a resectable lesion. Thus, distal pancreatectomy with en bloc celiac axis resection was performed and curability was achieved. There has been no tumor recurrence or distant metastasis at more than 12 months after surgery, and the patient remains alive at 17 months after initial chemotherapy.

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Authors and Affiliations

  1. Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, University of Miyazaki Faculty of Medicine, 5200 Kihara, Kiyotake, Miyazaki, 889-1692, Japan

    Masahide Hiyoshi, Atsushi Nanashima, Takashi Wada, Yuki Tsuchimochi, Takeomi Hamada, Koichi Yano, Naoya Imamura & Yoshiro Fujii

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  1. Masahide Hiyoshi
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  2. Atsushi Nanashima
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  3. Takashi Wada
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  4. Yuki Tsuchimochi
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  5. Takeomi Hamada
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  6. Koichi Yano
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  7. Naoya Imamura
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  8. Yoshiro Fujii
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Correspondence to Masahide Hiyoshi.

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All procedures followed have been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

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Informed consent was obtained from the patient for being included in this report.

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Hiyoshi, M., Nanashima, A., Wada, T. et al. A successful case of locally advanced pancreatic cancer undergoing curative distal pancreatectomy with en bloc celiac axis resection after combination chemotherapy of nab-paclitaxel with gemcitabine. Clin J Gastroenterol 10, 551–557 (2017). https://doi.org/10.1007/s12328-017-0793-5

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  • DOI: https://doi.org/10.1007/s12328-017-0793-5

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