Ann Hepatobiliary Pancreat Surg.  2021 Aug;25(3):390-394. 10.14701/ahbps.2021.25.3.390.

Complete response of locally advanced left-sided pancreatic cancer after modified FOLFIRINOX chemotherapy followed by conversion surgery: A case report

Affiliations
  • 1Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Yonsei University College of Medicine, Seoul, Korea
  • 2Division of Gastroenterology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
  • 3Pancreatobiliary Cancer Center, Yonsei Cancer Center, Severance Hospital, Seoul, Korea
  • 4Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, National Health Insurance Service Ilsan Hospital, Goyang, Korea

Abstract

For years, neoadjuvant chemotherapy for locally advanced pancreatic cancer is being investigated and radical surgical resection with laparoscopic approach is getting up to speed. Pathological complete remission is known as a predictive marker for a good prognosis for various carcinomas. Although there are a few case reports about pathological complete remission, there has been no case report of pathological complete remission resulted from successful extensive resection by laparoscopic surgery after a neoadjuvant modified FOLFIRINOX chemotherapy. A 68-year-old male patient was admitted due to a palpable abdominal mass which turned out to be 16-cm-sized huge locally advanced left-sided pancreatic cancer with possible stomach, left adrenal gland, left kidney, and colon invasion. After administration of 10th modified FOLFIRINOX chemotherapy, the tumor had decreased and he underwent laparoscopic radical distal pancreatectomy with splenectomy, left adrenalectomy, wedge resection of stomach, and segmental resection of transverse colon. Although patient had a postoperative micro-abscess around the colon anastomosis site, he was successfully managed with conservative treatment and discharged on 12 days postoperatively. The final pathology reported complete tumor regression. We hereby emphasize the oncologic significance of neoadjuvant chemotherapy in huge left-sided pancreatic cancer and the potential role of laparoscopic conversion surgery.

Keyword

Locally advanced pancreatic neoplasm; Neoadjuvant chemotherapy; Complete response; Laparoscopic surgery
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