Complete pathological response after neoadjuvant chemotherapy and the benefit of subsequent surgery in oligometastatic pancreatic cancer patient

Overview

Introduction: Pancreatic cancer is one of the most aggressive tumors diagnosed in local­ly advanced or metastatic stage in more than half of the cases. The standard of care is a systemic chemotherapy but the prognosis of metastatic patients remains extremely poor with a median overall survival less than one year.  However, there is increasing evidence of surgery treatment benefit in a carefully selected oligometastatic cases.  ­Because oligometastatic pancreatic cancer is rare, there is a lack of robust clinical trials defining strategy, efficacy and safety of this procedure.

Patient concerns: A 77-year-old man presented with a mass in the tail of the pancreas and solitary liver metastasis. After four cycles of chemotherapy, distal pancreatectomy with liver metastasectomy was performed, and the tissues were histologically examined. The complete pathological response was found in the primary tumor and residual adenocarcinoma in liver metastasis.

Outcomes: The patient is alive without recurrency more than two years from the diagnosis.

Keywords:

resection – Pancreas – carcinoma – oligometastatic