Preprint Case Report Version 1 This version is not peer-reviewed

Complete Response of Synchronous Liver Metastasis in a Pancreatic Ductal Adenocarcinoma: Could Surgery Represent a Therapeutic Option?

Version 1 : Received: 24 August 2019 / Approved: 27 August 2019 / Online: 27 August 2019 (05:16:03 CEST)

How to cite: Argentiero, A.; Brunetti, O.; Calabrese, A.; Sciacovelli, A.M.; Delcuratolo, S.; Solimando, A.G.; Silvestris, N. Complete Response of Synchronous Liver Metastasis in a Pancreatic Ductal Adenocarcinoma: Could Surgery Represent a Therapeutic Option?. Preprints 2019, 2019080278 (doi: 10.20944/preprints201908.0278.v1). Argentiero, A.; Brunetti, O.; Calabrese, A.; Sciacovelli, A.M.; Delcuratolo, S.; Solimando, A.G.; Silvestris, N. Complete Response of Synchronous Liver Metastasis in a Pancreatic Ductal Adenocarcinoma: Could Surgery Represent a Therapeutic Option?. Preprints 2019, 2019080278 (doi: 10.20944/preprints201908.0278.v1).

Abstract

Metastatic pancreatic ductal adenocarcinoma pancreatic (PDAC) is characterized by poor prognosis and short survival. Today, the use of new polytherapeutic regimens increases clinical outcome of these patients opening new clinical scenario. A crucial issue related to the actual improvement achieved with these new regimens is represented by the occasional possibility to observe a radiological complete response of metastatic lesions in patients with synchronous primary tumor. What could be the best therapeutic management of these patients? Could surgery represent an indication? Herein we reported a case of a patient with a PDAC of the head with multiple liver metastasis, who underwent first line chemotherapy with mFOLFIRINOX. After 10 cycles, he achieved a complete radiological response of liver metastases and a partial response of pancreatic lesion. A, duodenocephalopancreasectomy was performed. Due to liver a lung metastases after 8 months from surgery, a second line therapy was started with a disease free survival and overall survival of 8 months and 45 months, respectively. Improvement in the molecular characterization of PDAC could help in the selection of patients suitable for multimodal treatments.

Subject Areas

FOLFIRINOX; pancreatic ductal adenocarcinoma; surgery; liver metastases; long term survival

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