Dataset Information

Searching for novel multimodal treatments in oligometastatic pancreatic cancer.

ABSTRACT: BACKGROUND:Metastatic pancreatic cancer has a median overall survival of less than 12?months, even if treated with chemotherapy. Selected patients with oligometastatic disease could benefit from multimodal treatments connecting chemotherapy and surgical treatment or radiofrequency ablation (RFA) of metastases. CASE PRESENTATION:We present a patient with oligometastatic pancreatic cancer recurrence who was successfully treated with a multimodal therapeutic approach. A 57-year-old male initially presenting with resectable pancreatic cancer underwent pancreatoduodenectomy. The histopathological diagnosis revealed ductal pancreatic adenocarcinoma with positive surgical resection margins and negative lymph nodes. He completed six cycles of adjuvant therapy with gemcitabine (1000?mg/mq 1,8,15q 28), followed by external radiotherapy (54?Gy in 25 fractions) associated with gemcitabine 50?mg/mq twice weekly. Three years later, the patient developed multiple liver metastases, and he started FOLFIRINOX (oxaliplatin 85?mg/mq, irinotecan 180?mg/mq, leucovorin 400?mg/mq and fluorouracil 400?mg/mq given as a bolus followed by 2400?mg/mq as a 46?h continuous infusion,1q 14) as a first-line treatment. The CT scan showed a partial response after 6?cycles. After multidisciplinary discussion, the patient underwent a laparotomic metastasectomy of the three hepatic lesions. After additional postsurgical chemotherapy with 4?cycles of the FOLFIRINOX schedule, the patient remained free of recurrence for 12?months. A CT scan showed a new single liver metastasis, which was treated with radiofrequency ablation (RFA). A second radiofrequency ablation was performed when the patient developed another single liver lesion 12?months after the first RFA; currently, the patient is free from recurrence with an overall survival of 6?years from the diagnosis. CONCLUSIONS:Our case has benefited from successful multimodal treatment, including surgical and local ablative techniques and systemic chemotherapy. A multimodal approach may be warranted in selected patients with oligometastatic pancreatic cancer and could improve overall survival. Further research is needed to investigate this approach.

SUBMITTER: Filippini DM

PROVIDER: S-EPMC7106565 | biostudies-literature | 2020 Mar

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Searching for novel multimodal treatments in oligometastatic pancreatic cancer.

Filippini D M DM Grassi E E Palloni A A Carloni R R Casadei R R Ricci C C Serra C C Ercolani G G Brandi G G Di Marco M M

BMC cancer 20200330 1

<h4>Background</h4>Metastatic pancreatic cancer has a median overall survival of less than 12 months, even if treated with chemotherapy. Selected patients with oligometastatic disease could benefit from multimodal treatments connecting chemotherapy and surgical treatment or radiofrequency ablation (RFA) of metastases.<h4>Case presentation</h4>We present a patient with oligometastatic pancreatic cancer recurrence who was successfully treated with a multimodal therapeutic approach. A 57-year-old m ...[more]

PMID: 32228504

Similar Datasets

Project description:BackgroundSmall retrospective series suggest that local consolidative treatment (LCT) may improve survival in oligometastatic pancreatic ductal adenocarcinoma (PDAC). However, no uniform definition of oligometastatic disease (OMD) in PDAC exists; this impedes meaningful conclusions.Patients and methodsA systematic literature search using PubMed, Web of Science, and Cochrane CENTRAL registries for studies and protocols reporting on definitions and/or LCT of OMD in PDAC was performed. The primary endpoint was the definition of OMD. Levels of agreement were categorized as consensus (≥75% agreement between studies), fair agreement (50%-74%), and absent/poor agreement (<50%).ResultsAfter screening of 5374 abstracts, the full text of 218 studies was assessed, of which 76 were included in the qualitative synthesis. The majority of studies were retrospective (n = 66, 87%), two were prospective studies and eight were study protocols. Studies investigated mostly liver (n = 38, 51%) and lung metastases (n = 15, 20%). Across studies, less than one-half (n = 32, 42%) reported a definition of OMD, while 44 (58%) did not. Involvement was limited to a single organ (consensus). Additional criteria for defining OMD were the number of lesions (consensus), metastatic site (poor agreement), metastatic size (poor agreement), treatment possibilities (poor agreement), and biomarker response (poor agreement). Liver OMD could involve three or fewer lesions (consensus) and synchronous disease (fair agreement), while lung metastases could involve two or fewer lesions and metachronous disease (consensus). The large majority of studies were at a high risk of bias or did not include any control groups.ConclusionDefinitions of OMD were not used or varied widely between studies hampering across-study comparability and highlighting an unmet need for a consensus. The present study is part of a multistep process that aims to develop an interdisciplinary consensus on OMD in pancreatic cancer.

Dataset Information

Searching for novel multimodal treatments in oligometastatic pancreatic cancer.

Publications

Searching for novel multimodal treatments in oligometastatic pancreatic cancer.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets