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Unresectable Pancreatic Adenocarcinoma: Eight Years Later

Pancreatic cancer is the fourth leading cause of cancer deaths in the United States, and is considered uniformly fatal when patients present with unresectable, advanced-stage disease at the time of diagnosis. Long-term survival of patients with advanced-stage pancreatic adenocarcinoma remains rare,...

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Autores principales: Smiley, Kate, Malhotra, Reetu, Peche, William, Langell, John T.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elmer Press 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5624684/
https://www.ncbi.nlm.nih.gov/pubmed/28983358
http://dx.doi.org/10.14740/wjon957w
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author Smiley, Kate
Malhotra, Reetu
Peche, William
Langell, John T.
author_facet Smiley, Kate
Malhotra, Reetu
Peche, William
Langell, John T.
author_sort Smiley, Kate
collection PubMed
description Pancreatic cancer is the fourth leading cause of cancer deaths in the United States, and is considered uniformly fatal when patients present with unresectable, advanced-stage disease at the time of diagnosis. Long-term survival of patients with advanced-stage pancreatic adenocarcinoma remains rare, despite advances in adjuvant chemoradiation protocols. A 73-year-old male presented to our emergency department with abdominal pain and a history of biopsy-proven, stage III pancreatic adenocarcinoma. His initial staging CT scan and trans-duodenal ultrasound had demonstrated a stage IIa (T3, N0, Mx) lesion. On surgical exploration, he was up-staged to stage III (T4, N0, Mx), noting encasement of the superior mesenteric vessels and involvement of the portal vein. He underwent palliative choledochojejunostomy and was treated with 4 months of oxaliplatin and capecitabine, with concurrent radiation therapy (50.4 Gy), followed by 4 months of gemcitabine. After 7 months, the patient withdrew from therapy due to treatment intolerance. He then turned to self-medication with non-traditional herbal therapies. After 3 years of surveillance, he was lost to follow-up until presenting to our facility with abdominal pain 8 years after his initial diagnosis. On diagnostic CT scan during his current presentation for abdominal pain, he was found to have no evidence of pancreatic cancer. Based on our review of the literature, we present the longest known survival of a patient with surgically unresectable pancreatic adenocarcinoma. Further study of this patient’s phenotypic or genotypic characteristics may provide insight into better therapeutic agents, or a predictive subset of patients who will benefit from specific chemotherapeutic options.
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spelling pubmed-56246842017-10-05 Unresectable Pancreatic Adenocarcinoma: Eight Years Later Smiley, Kate Malhotra, Reetu Peche, William Langell, John T. World J Oncol Case Report Pancreatic cancer is the fourth leading cause of cancer deaths in the United States, and is considered uniformly fatal when patients present with unresectable, advanced-stage disease at the time of diagnosis. Long-term survival of patients with advanced-stage pancreatic adenocarcinoma remains rare, despite advances in adjuvant chemoradiation protocols. A 73-year-old male presented to our emergency department with abdominal pain and a history of biopsy-proven, stage III pancreatic adenocarcinoma. His initial staging CT scan and trans-duodenal ultrasound had demonstrated a stage IIa (T3, N0, Mx) lesion. On surgical exploration, he was up-staged to stage III (T4, N0, Mx), noting encasement of the superior mesenteric vessels and involvement of the portal vein. He underwent palliative choledochojejunostomy and was treated with 4 months of oxaliplatin and capecitabine, with concurrent radiation therapy (50.4 Gy), followed by 4 months of gemcitabine. After 7 months, the patient withdrew from therapy due to treatment intolerance. He then turned to self-medication with non-traditional herbal therapies. After 3 years of surveillance, he was lost to follow-up until presenting to our facility with abdominal pain 8 years after his initial diagnosis. On diagnostic CT scan during his current presentation for abdominal pain, he was found to have no evidence of pancreatic cancer. Based on our review of the literature, we present the longest known survival of a patient with surgically unresectable pancreatic adenocarcinoma. Further study of this patient’s phenotypic or genotypic characteristics may provide insight into better therapeutic agents, or a predictive subset of patients who will benefit from specific chemotherapeutic options. Elmer Press 2016-02 2016-04-03 /pmc/articles/PMC5624684/ /pubmed/28983358 http://dx.doi.org/10.14740/wjon957w Text en Copyright 2016, Smiley et al. http://creativecommons.org/licenses/by/2.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Smiley, Kate
Malhotra, Reetu
Peche, William
Langell, John T.
Unresectable Pancreatic Adenocarcinoma: Eight Years Later
title Unresectable Pancreatic Adenocarcinoma: Eight Years Later
title_full Unresectable Pancreatic Adenocarcinoma: Eight Years Later
title_fullStr Unresectable Pancreatic Adenocarcinoma: Eight Years Later
title_full_unstemmed Unresectable Pancreatic Adenocarcinoma: Eight Years Later
title_short Unresectable Pancreatic Adenocarcinoma: Eight Years Later
title_sort unresectable pancreatic adenocarcinoma: eight years later
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5624684/
https://www.ncbi.nlm.nih.gov/pubmed/28983358
http://dx.doi.org/10.14740/wjon957w
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AT langelljohnt unresectablepancreaticadenocarcinomaeightyearslater