[Long-Term Survival Following Multidisciplinary Therapy for Postoperative Recurrence of Pancreatic Cancer-A Case...

A woman in her 70s was diagnosed with borderline resectable pancreatic body cancer(cT3N0M0, Stage ⅢA)in 2014, with invasion of the celiac and splenic arteries. She received chemoradiotherapy(gemcitabine and 50.4 Gy radiotherapy), resulting in tumor shrinkage and decreased tumor markers. Distal pancreatectomy with celiac axis resection(DP-CAR)was performed in July 2015. Pathology confirmed pT3N1M0, Stage ⅢB pancreatic ductal adenocarcinoma. She received adjuvant S-1 therapy postoperatively. In April 2018, local retroperitoneal recurrence was detected, and modified FOLFIRINOX therapy was initiated. After 24 courses, S-1 was added, maintaining stable disease. Chemotherapy was discontinued in April 2020. In June 2023, PET-CT revealed FDG uptake near the right common iliac artery, diagnosed as para-aortic lymph node recurrence. She received radiotherapy(60 Gy/30 fr)combined with gemcitabine and S-1(GS therapy, 8 courses), resulting in tumor shrinkage. Due to isolated recurrence, laparoscopic lymphadenectomy with inferior vena cava resection was performed in January 2024. Histopathology was consistent with metastatic pancreatic adenocarcinoma. She remains recurrence-free and alive.