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

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.