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Case Report Open Access

Seven‑year survival with no recurrence after conversion surgery for pancreatic ductal adenocarcinoma with peritoneal metastasis treated with intraperitoneal and intravenous chemotherapy: A case report

  • Authors:
    • Mamoru Takahashi
    • Joe Matsumoto
    • Yoshinori Suzuki
    • Yumiko Oyamada
    • Yasushi Tsuji
    • Satoshi Hirano
  • View Affiliations / Copyright

    Affiliations: Department of Surgery, Tonan Hospital, Sapporo, Hokkaido 060‑0004, Japan, Department of Diagnostic Pathology, Tonan Hospital, Sapporo, Hokkaido 060‑0004, Japan, Department of Medical Oncology, Tonan Hospital, Sapporo, Hokkaido 060‑0004, Japan, Department of Gastrointestinal Surgery II, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido 060‑8648, Japan
    Copyright: © Takahashi et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Article Number: 113
    |
    Published online on: October 22, 2025
       https://doi.org/10.3892/mco.2025.2908
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Abstract

Pancreatic ductal adenocarcinoma (PDAC) has a poor prognosis, particularly PDAC with peritoneal metastases. The present report describes a case of distal pancreatectomy (DP) following ip and iv chemotherapy for PDAC with peritoneal metastases, with long‑term survival after CS. A 62‑year‑old man was referred to Tonan Hospital (Sapporo, Japan) for ip and iv chemotherapy after being diagnosed with unresectable pancreatic body adenocarcinoma with peritoneal dissemination at another hospital. The patient was administered four cycles of ip paclitaxel (ipPTX) plus ivPTX plus S‑1, followed by four cycles of ipPTX plus fluorouracil plus leucovorin, irinotecan and oxaliplatin. After 9 months of preoperative treatment, the disappearance of peritoneal dissemination was confirmed; thus, the patient underwent DP. The histopathological diagnosis was ypT2, ypN0, ypM0 and ypStage IB, and the histologic response to chemotherapy was grade IIb, according to the Evans classification. Postoperative adjuvant chemotherapy including ipPTX was administered for 12 months. The patient survived without recurrence for 7 years after the CS.
View Figures

Figure 1

Imaging findings. (A) Abdominal CT
before preoperative chemotherapy. The mass was obscure. (B)
Abdominal ultrasound before preoperative chemotherapy: A 16.3-mm
hypoechoic mass was identified in the pancreatic body (surrounded
by red arrowheads). (C) Abdominal CT before CS: No new lesions were
observed. (D) Abdominal CT after CS: No abnormal findings. (E)
Abdominal CT 7 years after CS. No new lesions were observed. CS,
conversion surgery; CT, computed tomography.

Figure 2

Pathological findings. (A)
Pathological findings for hematoxylin and eosin staining of the
peritoneal sample before preoperative chemotherapy: Adenocarcinoma.
Magnification, x100. (B) Surgical specimen of distal
pancreatectomy: Lesion of tumor (indicated by a yellow arrow). (C)
Pathological findings for hematoxylin and eosin staining of the
pancreas resected by distal pancreatectomy. Glandular structures
with irregular margins were observed (surrounded by black
arrowheads). Macrophages and granulation were observed in these
glandular structures, indicating the effect of preoperative
chemotherapy. Magnification, x40. (D) p53 immunostaining findings:
p53 expression was increased in the cells of the glandular
structures (surrounded by red arrowheads). Magnification, x40.

Figure 3

Diagnostic laparoscopy findings. (A)
Before preoperative chemotherapy: Several peritoneal white nodules
were observed. (B) After preoperative chemotherapy, two portions of
white peritoneal nodules were sampled and no peritoneal
dissemination was observed. Negative peritoneal lavage cytology was
observed.
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Copy and paste a formatted citation
Spandidos Publications style
Takahashi M, Matsumoto J, Suzuki Y, Oyamada Y, Tsuji Y and Hirano S: Seven‑year survival with no recurrence after conversion surgery for pancreatic ductal adenocarcinoma with peritoneal metastasis treated with intraperitoneal and intravenous chemotherapy: A case report. Mol Clin Oncol 23: 113, 2025.
APA
Takahashi, M., Matsumoto, J., Suzuki, Y., Oyamada, Y., Tsuji, Y., & Hirano, S. (2025). Seven‑year survival with no recurrence after conversion surgery for pancreatic ductal adenocarcinoma with peritoneal metastasis treated with intraperitoneal and intravenous chemotherapy: A case report. Molecular and Clinical Oncology, 23, 113. https://doi.org/10.3892/mco.2025.2908
MLA
Takahashi, M., Matsumoto, J., Suzuki, Y., Oyamada, Y., Tsuji, Y., Hirano, S."Seven‑year survival with no recurrence after conversion surgery for pancreatic ductal adenocarcinoma with peritoneal metastasis treated with intraperitoneal and intravenous chemotherapy: A case report". Molecular and Clinical Oncology 23.6 (2025): 113.
Chicago
Takahashi, M., Matsumoto, J., Suzuki, Y., Oyamada, Y., Tsuji, Y., Hirano, S."Seven‑year survival with no recurrence after conversion surgery for pancreatic ductal adenocarcinoma with peritoneal metastasis treated with intraperitoneal and intravenous chemotherapy: A case report". Molecular and Clinical Oncology 23, no. 6 (2025): 113. https://doi.org/10.3892/mco.2025.2908
Copy and paste a formatted citation
x
Spandidos Publications style
Takahashi M, Matsumoto J, Suzuki Y, Oyamada Y, Tsuji Y and Hirano S: Seven‑year survival with no recurrence after conversion surgery for pancreatic ductal adenocarcinoma with peritoneal metastasis treated with intraperitoneal and intravenous chemotherapy: A case report. Mol Clin Oncol 23: 113, 2025.
APA
Takahashi, M., Matsumoto, J., Suzuki, Y., Oyamada, Y., Tsuji, Y., & Hirano, S. (2025). Seven‑year survival with no recurrence after conversion surgery for pancreatic ductal adenocarcinoma with peritoneal metastasis treated with intraperitoneal and intravenous chemotherapy: A case report. Molecular and Clinical Oncology, 23, 113. https://doi.org/10.3892/mco.2025.2908
MLA
Takahashi, M., Matsumoto, J., Suzuki, Y., Oyamada, Y., Tsuji, Y., Hirano, S."Seven‑year survival with no recurrence after conversion surgery for pancreatic ductal adenocarcinoma with peritoneal metastasis treated with intraperitoneal and intravenous chemotherapy: A case report". Molecular and Clinical Oncology 23.6 (2025): 113.
Chicago
Takahashi, M., Matsumoto, J., Suzuki, Y., Oyamada, Y., Tsuji, Y., Hirano, S."Seven‑year survival with no recurrence after conversion surgery for pancreatic ductal adenocarcinoma with peritoneal metastasis treated with intraperitoneal and intravenous chemotherapy: A case report". Molecular and Clinical Oncology 23, no. 6 (2025): 113. https://doi.org/10.3892/mco.2025.2908
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