Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2019 Dec;35(6):387-391.
doi: 10.1159/000497827. Epub 2019 Apr 3.

Pathologic Complete Response of Pancreatic Cancer following Neoadjuvant FOLFIRINOX Treatment in Hepatic Metastasized Pancreatic Cancer

Andreas Minh Luu  1 , Philipp Hoehn  1 , Sina Rabea Vogel  1 , Anke Reinacher-Schick  2 , Johanna Munding  3 , Waldemar Uhl  1 , Chris Braumann  1
Affiliations
Case Reports

Pathologic Complete Response of Pancreatic Cancer following Neoadjuvant FOLFIRINOX Treatment in Hepatic Metastasized Pancreatic Cancer

Andreas Minh Luu et al. Visc Med. 2019 Dec.

Abstract

Introduction: Pancreatic cancer is a lethal disease and often asymptomatic. Therefore, it is most often diagnosed at an advanced stage. The standard approach in a metastasized tumor stage is palliative chemotherapy. However, the prognosis remains extremely poor.

Case report: We present the case of a patient who was diagnosed with a cancer of the head of the pancreas with hepatic metastases. After receiving palliative intended chemotherapy with the FOLFIRINOX regimen, staging computed tomography revealed the disappearance of the liver metastases and local resectability of the pancreatic head tumor. The patient underwent an uneventful Whipple's procedure. Surprisingly, pathohistological investigation revealed a complete pathological response.

Conclusion: Pathological complete response after FOLFIRINOX treatment in hepatic metastasized pancreatic cancer is extremely rare. It enables surgical resection and increases the survival rate significantly.

Keywords: FOLFIRINOX; Hepatic metastases; Pancreatic cancer; Pathologic complete response; ypT0.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no conflicts of interest. The study was not funded.

Figures

Fig. 1
Fig. 1
Contrast-enhanced CT scans of the patient before (a) and after (b) FOLFIRINOX treatment. a White arrow, pancreatic ductal adenocarcinoma of the pancreatic head; blue arrowhead, air in the duodenum. b White arrow, regressive pancreatic head cancer; red arrowhead, metal stent in the common bile duct.
Fig. 2
Fig. 2
a Specimen of the patent after Whipple's procedure. D, duodenum; S, stomach. b Intraoperative view of the pancreatic region. A loop is placed around the pancreatic neck. The duodenum has been separated from the stomach (blue arrow). Black arrow, pancreatic head with complete remission of the PC; white arrow, superior mesenteric vein; PB, pancreatic body; D, duodenum.
Fig. 3
Fig. 3
a Biopsy of the liver tumor in segment III revealing a metastasis of the pancreatic ductal adenocarcinoma (G2) before FOLFIRINOX treatment. b Specimen of the pancreatic head showing no viable tumor cells, but fibrosis and chronic inflammation.
See this image and copyright information in PMC

References

    1. Hidalgo M. Pancreatic cancer. N Engl J Med. 2010 Apr;362((17)):1605–17. - PubMed
    1. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2016. CA Cancer J Clin. 2016 Jan-Feb;66((1)):7–30. - PubMed
    1. Wagner M, Redaelli C, Lietz M, Seiler CA, Friess H, Büchler MW. Curative resection is the single most important factor determining outcome in patients with pancreatic adenocarcinoma. Br J Surg. 2004 May;91((5)):586–94. - PubMed
    1. Bond-Smith G, Banga N, Hammond TM, Imber CJ. Pancreatic adenocarcinoma. BMJ. 2012 May;344((may16 1)):e2476. - PubMed
    1. Katz MH, Pisters PW, Evans DB, Sun CC, Lee JE, Fleming JB, et al. Borderline resectable pancreatic cancer: the importance of this emerging stage of disease. J Am Coll Surg. 2008 May;206((5)):833–46. - PMC - PubMed

Publication types