Impact of pathological complete response following neoadjuvant chemotherapy (gemcitabine, nab-paclitaxel, S-1) and radiation for borderline resectable pancreatic cancer: a case report and review of literature

Abstract Background Pancreatic cancer (PC) is a highly lethal malignancy, even if surgical resection is possible (median survival: < 30 months). The prognosis of borderline resectable pancreatic cancer (BR-PC) is even worse. There is no clear consensus on the optimal treatment strategy, including...

Full description

Saved in:
Bibliographic Details
Main Authors: Mitsuru Kinoshita, Sota Watanabe, Gaku Mizojiri, Akitada Sada, Hiroki Kai, Yasunori Masuike, Yoshinobu Nagasawa, Kentaro Maruyama, Kyowon Lee, Mai Ohata, Osamu Ishikawa, Hiroshi Oka
Format: Article
Language:English
Published: Japan Surgical Society 2022-09-01
Series:Surgical Case Reports
Subjects:
Online Access:https://doi.org/10.1186/s40792-022-01529-z
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849411178369908736
author Mitsuru Kinoshita
Sota Watanabe
Gaku Mizojiri
Akitada Sada
Hiroki Kai
Yasunori Masuike
Yoshinobu Nagasawa
Kentaro Maruyama
Kyowon Lee
Mai Ohata
Osamu Ishikawa
Hiroshi Oka
author_facet Mitsuru Kinoshita
Sota Watanabe
Gaku Mizojiri
Akitada Sada
Hiroki Kai
Yasunori Masuike
Yoshinobu Nagasawa
Kentaro Maruyama
Kyowon Lee
Mai Ohata
Osamu Ishikawa
Hiroshi Oka
author_sort Mitsuru Kinoshita
collection DOAJ
description Abstract Background Pancreatic cancer (PC) is a highly lethal malignancy, even if surgical resection is possible (median survival: < 30 months). The prognosis of borderline resectable pancreatic cancer (BR-PC) is even worse. There is no clear consensus on the optimal treatment strategy, including pre/postoperative therapy, for BR-PC. We report a patient with BR-PC who achieved clinical partial response with neoadjuvant chemoradiation therapy (NACRT) and underwent curative resection, resulting in pathological complete response (pCR). Case presentation A 71-year-old man with jaundice and liver dysfunction was referred to our department because of a 48-mm hypo-vascular mass in the pancreatic head with obstruction of the pancreatic and bile ducts and infiltration of superior mesenteric vein and portal vein. The lesion was identified as atypical cells which suggested adenocarcinoma by biopsy, and he was administered NACRT: gemcitabine and nab-paclitaxel, following S-1 and intensity modulated radiation therapy. After reduction in the tumor size (clinical partial response), pancreaticoduodenectomy was performed, and pCR achieved. Postoperative adjuvant chemotherapy with S-1 was initially administered and the patient is currently alive with no recurrence as of 2 years after surgery. Conclusions NACRT is a potentially useful treatment for BR-PC that may lead to pCR and help improve prognosis.
format Article
id doaj-art-8cdc3e29d90e4d6596fe66b123ceca03
institution Kabale University
issn 2198-7793
language English
publishDate 2022-09-01
publisher Japan Surgical Society
record_format Article
series Surgical Case Reports
spelling doaj-art-8cdc3e29d90e4d6596fe66b123ceca032025-08-20T03:34:52ZengJapan Surgical SocietySurgical Case Reports2198-77932022-09-01811710.1186/s40792-022-01529-zImpact of pathological complete response following neoadjuvant chemotherapy (gemcitabine, nab-paclitaxel, S-1) and radiation for borderline resectable pancreatic cancer: a case report and review of literatureMitsuru Kinoshita0Sota Watanabe1Gaku Mizojiri2Akitada Sada3Hiroki Kai4Yasunori Masuike5Yoshinobu Nagasawa6Kentaro Maruyama7Kyowon Lee8Mai Ohata9Osamu Ishikawa10Hiroshi Oka11Department of Surgery, Moriguchi-Keijinkai HospitalDepartment of Surgery, Moriguchi-Keijinkai HospitalDepartment of Surgery, Moriguchi-Keijinkai HospitalDepartment of Surgery, Moriguchi-Keijinkai HospitalDepartment of Surgery, Moriguchi-Keijinkai HospitalDepartment of Surgery, Moriguchi-Keijinkai HospitalDepartment of Surgery, Moriguchi-Keijinkai HospitalDepartment of Surgery, Moriguchi-Keijinkai HospitalDepartment of Surgery, Moriguchi-Keijinkai HospitalDepartment of Pathology, Moriguchi-Keijinkai HospitalDepartment of Surgery, Moriguchi-Keijinkai HospitalDepartment of Surgery, Moriguchi-Keijinkai HospitalAbstract Background Pancreatic cancer (PC) is a highly lethal malignancy, even if surgical resection is possible (median survival: < 30 months). The prognosis of borderline resectable pancreatic cancer (BR-PC) is even worse. There is no clear consensus on the optimal treatment strategy, including pre/postoperative therapy, for BR-PC. We report a patient with BR-PC who achieved clinical partial response with neoadjuvant chemoradiation therapy (NACRT) and underwent curative resection, resulting in pathological complete response (pCR). Case presentation A 71-year-old man with jaundice and liver dysfunction was referred to our department because of a 48-mm hypo-vascular mass in the pancreatic head with obstruction of the pancreatic and bile ducts and infiltration of superior mesenteric vein and portal vein. The lesion was identified as atypical cells which suggested adenocarcinoma by biopsy, and he was administered NACRT: gemcitabine and nab-paclitaxel, following S-1 and intensity modulated radiation therapy. After reduction in the tumor size (clinical partial response), pancreaticoduodenectomy was performed, and pCR achieved. Postoperative adjuvant chemotherapy with S-1 was initially administered and the patient is currently alive with no recurrence as of 2 years after surgery. Conclusions NACRT is a potentially useful treatment for BR-PC that may lead to pCR and help improve prognosis.https://doi.org/10.1186/s40792-022-01529-zBorderline resectable pancreatic cancerNeoadjuvant chemoradiation therapyPathological complete response
spellingShingle Mitsuru Kinoshita
Sota Watanabe
Gaku Mizojiri
Akitada Sada
Hiroki Kai
Yasunori Masuike
Yoshinobu Nagasawa
Kentaro Maruyama
Kyowon Lee
Mai Ohata
Osamu Ishikawa
Hiroshi Oka
Impact of pathological complete response following neoadjuvant chemotherapy (gemcitabine, nab-paclitaxel, S-1) and radiation for borderline resectable pancreatic cancer: a case report and review of literature
Surgical Case Reports
Borderline resectable pancreatic cancer
Neoadjuvant chemoradiation therapy
Pathological complete response
title Impact of pathological complete response following neoadjuvant chemotherapy (gemcitabine, nab-paclitaxel, S-1) and radiation for borderline resectable pancreatic cancer: a case report and review of literature
title_full Impact of pathological complete response following neoadjuvant chemotherapy (gemcitabine, nab-paclitaxel, S-1) and radiation for borderline resectable pancreatic cancer: a case report and review of literature
title_fullStr Impact of pathological complete response following neoadjuvant chemotherapy (gemcitabine, nab-paclitaxel, S-1) and radiation for borderline resectable pancreatic cancer: a case report and review of literature
title_full_unstemmed Impact of pathological complete response following neoadjuvant chemotherapy (gemcitabine, nab-paclitaxel, S-1) and radiation for borderline resectable pancreatic cancer: a case report and review of literature
title_short Impact of pathological complete response following neoadjuvant chemotherapy (gemcitabine, nab-paclitaxel, S-1) and radiation for borderline resectable pancreatic cancer: a case report and review of literature
title_sort impact of pathological complete response following neoadjuvant chemotherapy gemcitabine nab paclitaxel s 1 and radiation for borderline resectable pancreatic cancer a case report and review of literature
topic Borderline resectable pancreatic cancer
Neoadjuvant chemoradiation therapy
Pathological complete response
url https://doi.org/10.1186/s40792-022-01529-z
work_keys_str_mv AT mitsurukinoshita impactofpathologicalcompleteresponsefollowingneoadjuvantchemotherapygemcitabinenabpaclitaxels1andradiationforborderlineresectablepancreaticcanceracasereportandreviewofliterature
AT sotawatanabe impactofpathologicalcompleteresponsefollowingneoadjuvantchemotherapygemcitabinenabpaclitaxels1andradiationforborderlineresectablepancreaticcanceracasereportandreviewofliterature
AT gakumizojiri impactofpathologicalcompleteresponsefollowingneoadjuvantchemotherapygemcitabinenabpaclitaxels1andradiationforborderlineresectablepancreaticcanceracasereportandreviewofliterature
AT akitadasada impactofpathologicalcompleteresponsefollowingneoadjuvantchemotherapygemcitabinenabpaclitaxels1andradiationforborderlineresectablepancreaticcanceracasereportandreviewofliterature
AT hirokikai impactofpathologicalcompleteresponsefollowingneoadjuvantchemotherapygemcitabinenabpaclitaxels1andradiationforborderlineresectablepancreaticcanceracasereportandreviewofliterature
AT yasunorimasuike impactofpathologicalcompleteresponsefollowingneoadjuvantchemotherapygemcitabinenabpaclitaxels1andradiationforborderlineresectablepancreaticcanceracasereportandreviewofliterature
AT yoshinobunagasawa impactofpathologicalcompleteresponsefollowingneoadjuvantchemotherapygemcitabinenabpaclitaxels1andradiationforborderlineresectablepancreaticcanceracasereportandreviewofliterature
AT kentaromaruyama impactofpathologicalcompleteresponsefollowingneoadjuvantchemotherapygemcitabinenabpaclitaxels1andradiationforborderlineresectablepancreaticcanceracasereportandreviewofliterature
AT kyowonlee impactofpathologicalcompleteresponsefollowingneoadjuvantchemotherapygemcitabinenabpaclitaxels1andradiationforborderlineresectablepancreaticcanceracasereportandreviewofliterature
AT maiohata impactofpathologicalcompleteresponsefollowingneoadjuvantchemotherapygemcitabinenabpaclitaxels1andradiationforborderlineresectablepancreaticcanceracasereportandreviewofliterature
AT osamuishikawa impactofpathologicalcompleteresponsefollowingneoadjuvantchemotherapygemcitabinenabpaclitaxels1andradiationforborderlineresectablepancreaticcanceracasereportandreviewofliterature
AT hiroshioka impactofpathologicalcompleteresponsefollowingneoadjuvantchemotherapygemcitabinenabpaclitaxels1andradiationforborderlineresectablepancreaticcanceracasereportandreviewofliterature