内容紹介
A Resected Case of Long-Term Survival of Pancreatic Cancer with Simultaneous Multiple Lung Metastasis with Systemic Chemotherapy
Summary
The patient was a 78-year-old man with resection of distal pancreatectomy for pancreatic cancer with simultaneous multiple lung metastasis. They were papillary and tubular adenocarcinoma, Pt, TS3, infiltrative type, ly0, v0, pT3, CH0, Du0, S1, RP1, PV0, A1(Asp), PL0, OO0 and pN0, M1(PUL), pStage Ⅳ. He was received gemcitabine after the surgery. S-1 was added because of lung metastasis progression. Chemotherapy was continued for about 10 years from resection, and intra-abdominal recurrence was not observed and good performance status was maintained. 5-year survival rate of pancreatic cancer is as low as about 6.5% in Stage Ⅳ. There are cases where lung resection to isolated lung metastasis are performed after resection of pancreas and long-term-survival are obtained. A resected case of long-term-survival of pancreatic cancer with simultaneous multiple lung metastasis is rare, so we will report with a few literature considerations.
要旨
他臓器転移を伴う進行膵癌の予後は極めて不良である。今回われわれは,多発肺転移を伴う膵癌に対し膵切除と術後化学療法を行い,10年の長期生存を得ている症例を経験したので報告する。症例は78歳,男性,検診で両肺の異常陰影を指摘され当院を受診した。精査の結果,多発肺転移を伴う膵尾部癌と診断した。膵体尾部切除術を施行し,術後gemcitabineによる全身化学療法を行った。肺転移の増悪を認めたためS-1を追加したところ,1年後のCTにてcomplete remissionを得た。休薬後に再増悪を認め化学療法を再開,その後用量と投与期間を調整し化学療法を継続しているが,両肺の転移は増大と縮小を繰り返しながらも腹腔内再発なども認めず,膵切除後10年経過した現在も良好なperformance statusを保っている。多発肺転移を伴う進行膵癌でも膵切除と化学療法を行うことにより,長期生存を得られる症例を経験した。
目次
Summary
The patient was a 78-year-old man with resection of distal pancreatectomy for pancreatic cancer with simultaneous multiple lung metastasis. They were papillary and tubular adenocarcinoma, Pt, TS3, infiltrative type, ly0, v0, pT3, CH0, Du0, S1, RP1, PV0, A1(Asp), PL0, OO0 and pN0, M1(PUL), pStage Ⅳ. He was received gemcitabine after the surgery. S-1 was added because of lung metastasis progression. Chemotherapy was continued for about 10 years from resection, and intra-abdominal recurrence was not observed and good performance status was maintained. 5-year survival rate of pancreatic cancer is as low as about 6.5% in Stage Ⅳ. There are cases where lung resection to isolated lung metastasis are performed after resection of pancreas and long-term-survival are obtained. A resected case of long-term-survival of pancreatic cancer with simultaneous multiple lung metastasis is rare, so we will report with a few literature considerations.
要旨
他臓器転移を伴う進行膵癌の予後は極めて不良である。今回われわれは,多発肺転移を伴う膵癌に対し膵切除と術後化学療法を行い,10年の長期生存を得ている症例を経験したので報告する。症例は78歳,男性,検診で両肺の異常陰影を指摘され当院を受診した。精査の結果,多発肺転移を伴う膵尾部癌と診断した。膵体尾部切除術を施行し,術後gemcitabineによる全身化学療法を行った。肺転移の増悪を認めたためS-1を追加したところ,1年後のCTにてcomplete remissionを得た。休薬後に再増悪を認め化学療法を再開,その後用量と投与期間を調整し化学療法を継続しているが,両肺の転移は増大と縮小を繰り返しながらも腹腔内再発なども認めず,膵切除後10年経過した現在も良好なperformance statusを保っている。多発肺転移を伴う進行膵癌でも膵切除と化学療法を行うことにより,長期生存を得られる症例を経験した。