Complete response in borderline resectable pancreatic cancer after modified FOLFIRINOX chemotherapy followed by surgical resection: a case report
Borderline resectable pancreatic cancer (BRPC) constitutes a challenging subset of cases that fall between clearly resectable and unresectable disease. Pancreatic cancer has a poor prognosis, with a 5-year survival rate of 4.2%. In patients who underwent surgical resection, the 5-year survival rate...
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| Main Authors: | , |
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| Format: | Article |
| Language: | English |
| Published: |
Kosin University College of Medicine
2025-06-01
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| Series: | Kosin Medical Journal |
| Subjects: | |
| Online Access: | http://www.kosinmedj.org/upload/pdf/kmj-24-158.pdf |
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| Summary: | Borderline resectable pancreatic cancer (BRPC) constitutes a challenging subset of cases that fall between clearly resectable and unresectable disease. Pancreatic cancer has a poor prognosis, with a 5-year survival rate of 4.2%. In patients who underwent surgical resection, the 5-year survival rate rose from 1.5% to 17.4%, whereas in those who did not undergo resection, it remained unchanged. Here, we present the case of a patient with BRPC who had no residual tumor during surgery after receiving neoadjuvant FOLFIRINOX chemotherapy. A 57-year-old male patient was hospitalized for abdominal pain and was referred to our hospital for recurrent pancreatitis due to persistent alcohol consumption. Tumor marker testing showed a carbohydrate antigen 19-9 level <2.00 U/mL and a carcinoembryonic antigen level of 4.32 ng/mL. Computed tomography and magnetic resonance cholangiopancreatography revealed signs suggestive of pancreatic cancer, including diffuse gallbladder wall thickening and pancreatic duct dilatation. Endoscopic ultrasound-guided fine needle aspiration biopsy was performed to obtain a tissue sample, and pathological examination confirmed pancreatic ductal adenocarcinoma. Positron emission tomography-computed tomography found no abnormal F-18 fluorodeoxyglucose uptake that would suggest metastasis. Pylorus-preserving pancreaticoduodenectomy was performed, and no visible tumor cells were detected in the resected pancreas after chemotherapy. The patient was followed up for >2 months after surgery without recurrence. The absence of a residual tumor during surgery after upfront chemotherapy in patients with pancreatic cancer is extremely rare and is reported here along with a review of the literature. |
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| ISSN: | 2005-9531 2586-7024 |