TY - JOUR
T1 - A Case of Robotic Distal Pancreatectomy for Pancreatic Metastasis of Gastric Cancer
AU - Nishimura, Akihiro
AU - Nakauchi, Masaya
AU - Fujita, Masahiro
AU - Umeki, Yusuke
AU - Goto, Ai
AU - Serizawa, Akiko
AU - Akimoto, Shingo
AU - Nakamura, Kenichi
AU - Tanaka, Tsuyoshi
AU - Shibasaki, Susumu
AU - Inaba, Kazuki
AU - Uyama, Ichiro
AU - Suda, Koichi
PY - 2022/12/1
Y1 - 2022/12/1
N2 - A 78-year-old male who had received laparoscopic total gastrectomy for upper gastric cancer 30 months ago(pT3N0, pStage ⅡB)was referred for further treatment for a 30-mm in size mass at the splenic hilum. The mass was suspected of lymph node metastasis was suspected. Two courses of SOX therapy failed to achieve the tumor response. Since there was no other metastasis, surgical treatment was indicated. Robot distal pancreatectomy with splenectomy was performed. There was no finding of peritoneal metastasis during the operation. The operative time was 384 min, the blood loss 22 mL, respectively. The postoperative course was uneventful, and he was discharged on the 12th postoperative day. The histopathological examination found that the resected mass was pancreatic metastasis of gastric cancer. Despite 3 courses of SOX therapy after the operation, the tumor recurred at the liver and paraaortic lymph nodes 2 months later. The second-line ramucirumab plus paclitaxel was started and has continued for 11 months with partial response. Although oncological benefit of surgical resection for isolated metastasis of gastric cancer, including pancreatic metastasis, was unclear, the robotic approach for such an atypical case was safe and feasible, leading to smooth initiation of postoperative systemic therapy.
AB - A 78-year-old male who had received laparoscopic total gastrectomy for upper gastric cancer 30 months ago(pT3N0, pStage ⅡB)was referred for further treatment for a 30-mm in size mass at the splenic hilum. The mass was suspected of lymph node metastasis was suspected. Two courses of SOX therapy failed to achieve the tumor response. Since there was no other metastasis, surgical treatment was indicated. Robot distal pancreatectomy with splenectomy was performed. There was no finding of peritoneal metastasis during the operation. The operative time was 384 min, the blood loss 22 mL, respectively. The postoperative course was uneventful, and he was discharged on the 12th postoperative day. The histopathological examination found that the resected mass was pancreatic metastasis of gastric cancer. Despite 3 courses of SOX therapy after the operation, the tumor recurred at the liver and paraaortic lymph nodes 2 months later. The second-line ramucirumab plus paclitaxel was started and has continued for 11 months with partial response. Although oncological benefit of surgical resection for isolated metastasis of gastric cancer, including pancreatic metastasis, was unclear, the robotic approach for such an atypical case was safe and feasible, leading to smooth initiation of postoperative systemic therapy.
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M3 - Article
C2 - 36733026
AN - SCOPUS:85147319607
SN - 0385-0684
VL - 49
SP - 1867
EP - 1869
JO - Gan to kagaku ryoho. Cancer & chemotherapy
JF - Gan to kagaku ryoho. Cancer & chemotherapy
IS - 13
ER -