Simultaneous Distal Pancreatic Resection and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) for Peritoneal Carcinomatosis in Adenocarcinoma of the Pancreas - A Case Report

TY - JOUR

T1 - Simultaneous Distal Pancreatic Resection and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) for Peritoneal Carcinomatosis in Adenocarcinoma of the Pancreas - A Case Report

AU - Bardenhagen, Jan

AU - Goetz, Mara

AU - Izbicki, Jakob

AU - Uzunoglu, Faik Güntac

N1 - Celsius.

PY - 2022/6

Y1 - 2022/6

N2 - Pancreatic cancer remains one of the biggest challenges in oncology, as most patients are diagnosed in a stage of regional lymphatic or systemic spread of the disease. 10% of the patients present with peritoneal carcinomatosis upon diagnosis. In the past decades, cytoreductive surgery (CRS) combined with hyperthermic intraoperative intraperitoneal chemotherapy (HIPEC) has been developed and presents a new, individualized treatment option for patients with peritoneal disseminated cancer. This case report presents the case of a 39-year-old male with the initial diagnosis of a carcinoma of the pancreatic tail with localized peritoneal carcinomatosis. As an individualized approach, neoadjuvant chemotherapy was recommended with an option for a second exploration. Re-Staging revealed a reduction in tumor size. Cytoreductive surgery (CRS) including a distal splenopancreatectomy was performed and followed by HIPEC. Postoperatively, the patient developed a clinically relevant pancreatic fistula, however recovered and was able to receive adjuvant chemotherapy. Taken together, in pancreatic cancer with localized peritoneal carcinomatosis CRS and HIPEC are a valid option in highly selective cases with potential extended overall survival and an acceptable quality of life.

AB - Pancreatic cancer remains one of the biggest challenges in oncology, as most patients are diagnosed in a stage of regional lymphatic or systemic spread of the disease. 10% of the patients present with peritoneal carcinomatosis upon diagnosis. In the past decades, cytoreductive surgery (CRS) combined with hyperthermic intraoperative intraperitoneal chemotherapy (HIPEC) has been developed and presents a new, individualized treatment option for patients with peritoneal disseminated cancer. This case report presents the case of a 39-year-old male with the initial diagnosis of a carcinoma of the pancreatic tail with localized peritoneal carcinomatosis. As an individualized approach, neoadjuvant chemotherapy was recommended with an option for a second exploration. Re-Staging revealed a reduction in tumor size. Cytoreductive surgery (CRS) including a distal splenopancreatectomy was performed and followed by HIPEC. Postoperatively, the patient developed a clinically relevant pancreatic fistula, however recovered and was able to receive adjuvant chemotherapy. Taken together, in pancreatic cancer with localized peritoneal carcinomatosis CRS and HIPEC are a valid option in highly selective cases with potential extended overall survival and an acceptable quality of life.

KW - Adenocarcinoma

KW - Adult

KW - Antineoplastic Combined Chemotherapy Protocols/therapeutic use

KW - Chemotherapy, Cancer, Regional Perfusion

KW - Combined Modality Therapy

KW - Humans

KW - Hyperthermia, Induced

KW - Hyperthermic Intraperitoneal Chemotherapy

KW - Male

KW - Pancreas

KW - Pancreatic Neoplasms/drug therapy

KW - Peritoneal Neoplasms/drug therapy

KW - Quality of Life

KW - Survival Rate

KW - Treatment Outcome

U2 - 10.21614/chirurgia.2630

DO - 10.21614/chirurgia.2630

M3 - SCORING: Journal article

C2 - 36049107

VL - 117

SP - 486

EP - 492

JO - CHIRURGIA-BUCHAREST

JF - CHIRURGIA-BUCHAREST

SN - 1221-9118

IS - 4

ER -