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Pancreatic Cancer Case Studies

Case Studies: Improving the Treatment of Locally Advanced Pancreatic Cancer

John Marshall, MD, reviews the diagnosis and treatment of a 64-year-old woman who presents with locally advanced pancreatic adenocarcinoma.

Improving the Treatment of Locally Advanced Pancreatic Cancer

May 2017

  • A 64-year-old female was diagnosed with locally advanced pancreatic adenocarcinoma and referred for consultation at a high-volume center
  • CT with contrast showed a 2.8-cm mass in the pancreatic body, invading the common hepatic, celiac, and splenic arteries, with abutment more than 180° to the superior mesenteric artery (SMA) but no encasement
  • Staging laparoscopy showed no distant metastasis; peritoneal washing cytology showed no malignant cells
  • She received FOLFIRINOX followed by capecitabine and concurrent RT

December 2017

  • Six months after the initial treatment, the tumor size had decreased to 1.2 cm, and abutment to the main artery was diminished but still detectable
  • She underwent distal pancreatectomy with celiac artery resection
  • Histopathology showed fibrous changes around the celiac artery; Evans grade IIb
  • No evidence of residual tumor at the periphery; R0
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