Salvage pancreaticoduodenectomy after complete response to chemoradiotherapy for a previously unresectable pancreatic adenosquamous carcinoma: a case report. Medicine (Baltimore) 2015 Feb;94(6):e499
Date
02/13/2015Pubmed ID
25674740Pubmed Central ID
PMC4602766DOI
10.1097/MD.0000000000000499Scopus ID
2-s2.0-84928588019 (requires institutional sign-in at Scopus site) 5 CitationsAbstract
Pancreatic cancer is known for its typically late presentation and poor survival rates, with overall 5-year survival of less than 5%. The role of chemotherapy alone or with radiotherapy in the management of locally advanced tumors continues to be an area of debate.We report a case of locally advanced, pancreatic adenosquamous carcinoma that was initially deemed unresectable intraoperatively. Nonetheless, the tumor was resected after radiological response to gemcitabine-capecitabine chemoradiotherapy regimen similar to the Selective Chemoradiation in Advanced LOcalised Pancreatic cancer trial. Histological examination revealed complete pathological response with extensive fibrosis (ypT0 N0). On 12-month follow-up CT, a single liver lesion in the left lateral segment was identified and confirmed to be a metastasis with cytological diagnosis via EUS and FNA. The disease remained stable and confined to the solitary hepatic metastasis after further gemcitabine chemotherapy. Therefore, a further successful resection was performed.The 2 main strategies for the management of locally advanced unresectable pancreatic cancer are chemotherapy induction followed by consolidation chemoradiotherapy or chemotherapy alone, with conflicting published evidence. Evidence for the optimal management of the rare histological type of adenosquamous carcinoma is scant. We present a case of such tumor with a complete pathological response to chemoradiotherapy. The results of future studies in the area are eagerly awaited.
Author List
Elias A, Chatzizacharias NA, Xanthis A, Corrie P, Davies S, Brais RJ, Jamieson NV, Praseedom RK, Huguet E, Harper SJF, Jah AMESH terms used to index this publication - Major topics in bold
Antineoplastic Combined Chemotherapy ProtocolsCapecitabine
Carcinoma, Adenosquamous
Chemoradiotherapy
Combined Modality Therapy
Deoxycytidine
Female
Fluorouracil
Humans
Middle Aged
Pancreatic Neoplasms
Pancreaticoduodenectomy
Salvage Therapy
