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Pancreaticoduodenectomy after neoadjuvant chemotherapy for gastric cancer invading the pancreatic head: A case report
BACKGROUND: Pancreaticoduodenectomy (PD) for advanced gastric cancer is rarely performed because of the high morbidity and mortality rates and low survival rate. However, neoadjuvant chemotherapy for advanced gastric cancer has improved, and chemotherapy combined with trastuzumab may have a preopera...
Autores principales: | , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Baishideng Publishing Group Inc
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7896433/ https://www.ncbi.nlm.nih.gov/pubmed/33642827 http://dx.doi.org/10.3748/wjg.v27.i6.534 |
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author | Yura, Masahiro Takano, Kiminori Adachi, Kiyohiko Hara, Asuka Hayashi, Keita Tajima, Yuki Kaneko, Yasushi Ikoma, Yoichiro Fujisaki, Hiroto Hirata, Akira Hongo, Kumiko Yo, Kikuo Yoneyama, Kimiyasu Dehari, Reiko Koyanagi, Kazuo Nakagawa, Motohito |
author_facet | Yura, Masahiro Takano, Kiminori Adachi, Kiyohiko Hara, Asuka Hayashi, Keita Tajima, Yuki Kaneko, Yasushi Ikoma, Yoichiro Fujisaki, Hiroto Hirata, Akira Hongo, Kumiko Yo, Kikuo Yoneyama, Kimiyasu Dehari, Reiko Koyanagi, Kazuo Nakagawa, Motohito |
author_sort | Yura, Masahiro |
collection | PubMed |
description | BACKGROUND: Pancreaticoduodenectomy (PD) for advanced gastric cancer is rarely performed because of the high morbidity and mortality rates and low survival rate. However, neoadjuvant chemotherapy for advanced gastric cancer has improved, and chemotherapy combined with trastuzumab may have a preoperative tumor-reducing effect, especially for human epidermal growth factor receptor 2 (HER2)-positive cases. CASE SUMMARY: We report a case of successful radical resection with PD after neoadjuvant S-1 plus oxaliplatin (SOX) and trastuzumab in a patient (66-year-old male) with advanced gastric cancer invading the pancreatic head. Initial esophagogastroduodenoscopy detected a type 3 advanced lesion located on the lower part of the stomach obstructing the pyloric ring. Computed tomography detected lymph node metastasis and tumor invasion to the pancreatic head without distant metastasis. Pathological findings revealed adenocarcinoma and HER2 positivity (immunohistochemical score of 3 +). We performed staging laparoscopy and confirmed no liver metastasis, no dissemination, negative lavage cytological findings, and immobility of the distal side of the stomach due to invasion to the pancreas. Laparoscopic gastrojejunostomy was performed at that time. One course of SOX and three courses of SOX plus trastuzumab were administered. Preoperative computed tomography showed partial response; therefore, PD was performed after neoadjuvant chemotherapy, and pathological radical resection was achieved. CONCLUSION: We suggest that radical resection with PD after neoadjuvant chemotherapy plus trastuzumab is an option for locally advanced HER2-positive gastric cancer invading the pancreatic head in the absence of non-curative factors. |
format | Online Article Text |
id | pubmed-7896433 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Baishideng Publishing Group Inc |
record_format | MEDLINE/PubMed |
spelling | pubmed-78964332021-02-25 Pancreaticoduodenectomy after neoadjuvant chemotherapy for gastric cancer invading the pancreatic head: A case report Yura, Masahiro Takano, Kiminori Adachi, Kiyohiko Hara, Asuka Hayashi, Keita Tajima, Yuki Kaneko, Yasushi Ikoma, Yoichiro Fujisaki, Hiroto Hirata, Akira Hongo, Kumiko Yo, Kikuo Yoneyama, Kimiyasu Dehari, Reiko Koyanagi, Kazuo Nakagawa, Motohito World J Gastroenterol Case Report BACKGROUND: Pancreaticoduodenectomy (PD) for advanced gastric cancer is rarely performed because of the high morbidity and mortality rates and low survival rate. However, neoadjuvant chemotherapy for advanced gastric cancer has improved, and chemotherapy combined with trastuzumab may have a preoperative tumor-reducing effect, especially for human epidermal growth factor receptor 2 (HER2)-positive cases. CASE SUMMARY: We report a case of successful radical resection with PD after neoadjuvant S-1 plus oxaliplatin (SOX) and trastuzumab in a patient (66-year-old male) with advanced gastric cancer invading the pancreatic head. Initial esophagogastroduodenoscopy detected a type 3 advanced lesion located on the lower part of the stomach obstructing the pyloric ring. Computed tomography detected lymph node metastasis and tumor invasion to the pancreatic head without distant metastasis. Pathological findings revealed adenocarcinoma and HER2 positivity (immunohistochemical score of 3 +). We performed staging laparoscopy and confirmed no liver metastasis, no dissemination, negative lavage cytological findings, and immobility of the distal side of the stomach due to invasion to the pancreas. Laparoscopic gastrojejunostomy was performed at that time. One course of SOX and three courses of SOX plus trastuzumab were administered. Preoperative computed tomography showed partial response; therefore, PD was performed after neoadjuvant chemotherapy, and pathological radical resection was achieved. CONCLUSION: We suggest that radical resection with PD after neoadjuvant chemotherapy plus trastuzumab is an option for locally advanced HER2-positive gastric cancer invading the pancreatic head in the absence of non-curative factors. Baishideng Publishing Group Inc 2021-02-14 2021-02-14 /pmc/articles/PMC7896433/ /pubmed/33642827 http://dx.doi.org/10.3748/wjg.v27.i6.534 Text en ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved. http://creativecommons.org/licenses/by-nc/4.0/ This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. |
spellingShingle | Case Report Yura, Masahiro Takano, Kiminori Adachi, Kiyohiko Hara, Asuka Hayashi, Keita Tajima, Yuki Kaneko, Yasushi Ikoma, Yoichiro Fujisaki, Hiroto Hirata, Akira Hongo, Kumiko Yo, Kikuo Yoneyama, Kimiyasu Dehari, Reiko Koyanagi, Kazuo Nakagawa, Motohito Pancreaticoduodenectomy after neoadjuvant chemotherapy for gastric cancer invading the pancreatic head: A case report |
title | Pancreaticoduodenectomy after neoadjuvant chemotherapy for gastric cancer invading the pancreatic head: A case report |
title_full | Pancreaticoduodenectomy after neoadjuvant chemotherapy for gastric cancer invading the pancreatic head: A case report |
title_fullStr | Pancreaticoduodenectomy after neoadjuvant chemotherapy for gastric cancer invading the pancreatic head: A case report |
title_full_unstemmed | Pancreaticoduodenectomy after neoadjuvant chemotherapy for gastric cancer invading the pancreatic head: A case report |
title_short | Pancreaticoduodenectomy after neoadjuvant chemotherapy for gastric cancer invading the pancreatic head: A case report |
title_sort | pancreaticoduodenectomy after neoadjuvant chemotherapy for gastric cancer invading the pancreatic head: a case report |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7896433/ https://www.ncbi.nlm.nih.gov/pubmed/33642827 http://dx.doi.org/10.3748/wjg.v27.i6.534 |
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