Conversion Surgery Combined with Preoperative Coil Embolization of Hepatic Artery for Locally Advanced Unresectable Pancreatic Head Cancer with Hepatic Artery Invasion-A Case Report

Shingo Toyama, Masamichi Mizuma, Hiroki Hayashi, Masahiro Iseki, Tatsuyuki Takadate, Kyohei Ariake, Kunihiro Masuda, Masaharu Ishida, Hideo Ohtsuka, Kei Nakagawa, Takanori Morikawa, Fuyuhiko Motoi, Takashi Kamei, Takeshi Naito, Michiaki Unno

研究成果: Article査読

抄録

Here we report a case treated with conversion surgery combined with preoperative coil embolization of the hepatic artery after chemoradiation therapy for locally advanced unresectable pancreatic head cancer with hepatic artery invasion. A 63- year-old man was referred to our hospital for treatment of pancreatic cancer. Abdominal CT scan revealed a 30mm pancreatic head tumor with involvement of the common hepatic artery(CHA)and proper hepatic artery(PHA). The left hepatic artery diverged from the left gastric artery. Although S-1 with concurrent radiation therapy was performed, a follow-up CT scan revealed the progression of soft tissue shadow around the CHA. Subsequently, gemcitabine plus nab-paclitaxel(GnP)was administered 13 times. GnP helped achieve normalization of the tumor markers and long stable disease(SD)based on the Response Evaluation Criteria in Solid Tumors(RECIST). For the conversion surgery, embolization of the middle hepatic artery (MHA)was performed. Twelve days after, the right hepatic artery was embolized. Subtotal stomach-preserving pancreaticoduodenectomy was performed with resection of the CHA and PHA without arterial reconstruction 16 days after the hepatic arterial embolization. The patient was discharged from our hospital 33 days after surgery without complications related to hepatic ischemia. The patient is alive without recurrence 42 months after the initial diagnosis and 26 months after surgery.

本文言語English
ページ(範囲)2309-2311
ページ数3
ジャーナルGan to kagaku ryoho. Cancer & chemotherapy
45
13
出版ステータスPublished - 2018 12 1

ASJC Scopus subject areas

  • 腫瘍学
  • 癌研究

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