Two Cases of Unresectable Pancreatic Cancer Treated with Neoadjuvant Chemotherapy and Surgical Resection

  • Huh, Gunn (Department of Internal Medicine, Liver Research Institute, Seoul National University Hospital, Seoul National University College of Medicine) ;
  • Chun, Jung Won (Department of Internal Medicine, Liver Research Institute, Seoul National University Hospital, Seoul National University College of Medicine) ;
  • You, Min Su (Department of Internal Medicine, Liver Research Institute, Seoul National University Hospital, Seoul National University College of Medicine) ;
  • Paik, Woo Hyun (Department of Internal Medicine, Liver Research Institute, Seoul National University Hospital, Seoul National University College of Medicine) ;
  • Lee, Sang Hyub (Department of Internal Medicine, Liver Research Institute, Seoul National University Hospital, Seoul National University College of Medicine) ;
  • Kim, Yong-Tae (Department of Internal Medicine, Liver Research Institute, Seoul National University Hospital, Seoul National University College of Medicine) ;
  • Ryu, Ji Kon (Department of Internal Medicine, Liver Research Institute, Seoul National University Hospital, Seoul National University College of Medicine)
  • Received : 2019.11.29
  • Accepted : 2019.12.09
  • Published : 2019.12.31

Abstract

We report two cases of patients with unresectable pancreatic cancer treated with neoadjuvant chemotherapy and surgical resection. In the first case, main mass was located at the neck of the pancreas, encasing superior mesenteric artery and peritoneal seeding was suspected. In the second case, main mass was located at the body of pancreas and superior mesenteric artery was encased. Both patients received FOLFIRINOX chemotherapy regimen, consisting of 5-FU, folinic acid, irinotecan and oxaliplatin. In both cases, tumor size decreased and vascular involvement regressed in response to chemotherapy. After subsequent chemoradiation therapy, both patients underwent surgical resection with negative resection margin. The pathological stages were ypT1cN0 and ypT1aN0, respectively. Both patients received postoperative adjuvant chemotherapy with 6 cycles of 5-FU/folinic acid and remained without evidence of disease for more than 6 months after the surgery.

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