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Pancreaticoduodenectomy after neoadjuvant chemotherapy for gastric cancer invading the pancreatic head:A case report

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World Journal of Gastroenterology 2021年第6期27卷 534-544页

作者： Masahiro Yura Kiminori Takano Kiyohiko Adachi Asuka Hara Keita Hayashi Yuki Tajima Yasushi Kaneko yoichiro ikoma Hiroto Fujisaki Akira Hirata Kumiko Hongo Kikuo Yo Kimiyasu Yoneyama Reiko Dehari Kazuo Koyanagi Motohito Nakagawa Department of Surgery Hiratsuka City HospitalHiratsuka 2540065KanagawaJapan Department of Surgical Pathology Hiratsuka City HospitalHiratsuka 2540065KanagawaJapan Department of Gastroenterological Surgery Tokai University School of MedicineIsehara 259193KanagawaJapan

BACKGROUND Pancreaticoduodenectomy(PD)for advanced gastric cancer is rarely performed because of the high morbidity and mortality rates and low survival ***,neoadjuvant chemotherapy for advanced gastric cancer has improved,and chemotherapy combined with trastuzumab may have a preoperative tumorreducing effect,especially for human epidermal growth factor receptor 2(HER2)-positive *** 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 *** esophagogastroduodenoscopy detected a type 3 advanced lesion located on the lower part of the stomach obstructing the pyloric *** tomography detected lymph node metastasis and tumor invasion to the pancreatic head without distant *** 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 *** gastrojejunostomy was performed at that *** course of SOX and three courses of SOX plus trastuzumab were *** computed tomography showed partial response;therefore,PD was performed after neoadjuvant chemotherapy,and pathological radical resection was *** 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.

关键词： Pancreaticoduodenectomy Gastric cancer Neoadjuvant chemotherapy Trastuzumab Human epidermal growth factor receptor 2 Case report

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