A Case of Locally Advanced Gastric Cancer - R0 Resection Was Performed by Pancreaticoduodenectomy with Portal Vein Resection Following Neoadjuvant Therapy

A 76-year-old woman, complained of weight loss, was admitted in our hospital. After investigation, she was diagnosed with clinical Stage III B gastric cancer with invasion into the pancreas and transverse colon. After performing the staging laparoscopy and gastrojejunostomy for pyloric stenosis, she was treated with 2 courses of SOX therapy as neoadjuvant therapy, and subsequently underwent pancreaticoduodenectomy and right hemicolectomy combined with portal vein resection due to severe adhesion by the tumor. The pathological diagnosis was pT4b(colon), pN0(0/22), pM0, pStage III B. There were no findings of tumor invasion into the pancreas or the portal vein. She was discharged without any complications. She did not receive the adjuvant chemotherapy, and died of other illness at 10 months after surgery. For the locally advanced gastric cancer such as invasion to the pancreas, the extended resection as an R0 resection could be achieved more safely, by evaluating accurately the incurable factors and planning an effective strategy according to the patient's condition.