内容紹介
Summary
We report a case of locally advanced pancreatic body cancer, accomplishing R0 resection following preoperative chemotherapy. An 80-year-old female patient was admitted to our hospital because of high CA19-9 levels. Based on computed tomography images, she was diagnosed with locally advanced cancer of the pancreatic body. We started S-1 chemotherapy(100 mg/day, 2 weeks administration 1 week rest)because the tumor was suspected to have invaded the celiac trunk and the common hepatic artery. The tumor decreased in size, and the encasement of the celiac trunk and the common hepatic artery were released, following 6 months of chemotherapy. Subsequently, distal pancreatectomy with D2 lymph node dissection was performed. The patient was healthy and showed no signs of recurrence 5 years and 9 months after surgery.
要旨
症例は80歳,女性。2010年10月に紹介医での血液検査でCA19-9が58 U/mLであったため,精査目的に当院紹介となった。精査にて腹腔動脈に接触浸潤が疑われるborderline resectable(BR)膵体部癌と診断した。術前化学療法の方針としたが,年齢を考慮しS-1単独(100 mg/day,2週投与1週休薬)での治療を開始した。開始2か月後には腫瘍マーカーが基準値以下になり,3か月後のCT検査で腫瘍の縮小を認めた。切除可能と判断し,化学療法開始6か月後に膵体尾部切除,脾臓摘出術を施行した。病理結果はPb,TS1(10 mm),tubular,well differentiated adenocarcinoma,int,INF β,ly0,v0,ne0,mpd0,yT1c,ypCH0,ypDu0,ypS0,ypRP0; ypPV0,ypA0,ypPL0,ypOO0,pN0,ypPCM0,ypBCM0,ypDPM0,TNM分類: ypT1,ypN0,M0,ypStageⅠで組織学的効果判定はgrade 2(膵癌取扱い規約第7版)であった。術後1年6か月S-1による補助化学療法を継続し,終了している。現在術後5年9か月経過し,無再発生存中である。
目次
We report a case of locally advanced pancreatic body cancer, accomplishing R0 resection following preoperative chemotherapy. An 80-year-old female patient was admitted to our hospital because of high CA19-9 levels. Based on computed tomography images, she was diagnosed with locally advanced cancer of the pancreatic body. We started S-1 chemotherapy(100 mg/day, 2 weeks administration 1 week rest)because the tumor was suspected to have invaded the celiac trunk and the common hepatic artery. The tumor decreased in size, and the encasement of the celiac trunk and the common hepatic artery were released, following 6 months of chemotherapy. Subsequently, distal pancreatectomy with D2 lymph node dissection was performed. The patient was healthy and showed no signs of recurrence 5 years and 9 months after surgery.
要旨
症例は80歳,女性。2010年10月に紹介医での血液検査でCA19-9が58 U/mLであったため,精査目的に当院紹介となった。精査にて腹腔動脈に接触浸潤が疑われるborderline resectable(BR)膵体部癌と診断した。術前化学療法の方針としたが,年齢を考慮しS-1単独(100 mg/day,2週投与1週休薬)での治療を開始した。開始2か月後には腫瘍マーカーが基準値以下になり,3か月後のCT検査で腫瘍の縮小を認めた。切除可能と判断し,化学療法開始6か月後に膵体尾部切除,脾臓摘出術を施行した。病理結果はPb,TS1(10 mm),tubular,well differentiated adenocarcinoma,int,INF β,ly0,v0,ne0,mpd0,yT1c,ypCH0,ypDu0,ypS0,ypRP0; ypPV0,ypA0,ypPL0,ypOO0,pN0,ypPCM0,ypBCM0,ypDPM0,TNM分類: ypT1,ypN0,M0,ypStageⅠで組織学的効果判定はgrade 2(膵癌取扱い規約第7版)であった。術後1年6か月S-1による補助化学療法を継続し,終了している。現在術後5年9か月経過し,無再発生存中である。