AN UNUSUALLY PROLONGED SURVIVAL IN METASTATIC PERIAMPULLARY PANCREATIC ADENOCARCINOMA
Abstract
Periampullary cancer is the term used for neoplasms arising from the head of pancreas, ampulla of Vater, distal bile duct and periampullary region of duodenum. Of these, the pancreatic adenocarcinoma carries the worst prognosis with majority of mortalities within the 1st year. The overall 5-year survival is <3%. Studies have shown that pancreatic carcinoma has the shortest median survival of 17.1 months of all periampullary carcinomas. With the development of metastasis, the median survival tends to reduce to 3–6 months. We are reporting a case of metastatic periampullary pancreatic adenocarcinoma that received minimal and interrupted chemotherapy due to poor tolerance and yet managed to survive far beyond the reported median survival.
Key words: Adenocarcinoma, pancreas, periampullary, prognosis
References
Fernandez-Cruz L. Peri ampullary carcinoma. In: Holzheimer RG, Mannick JA, editors. Surgical Treatment: Evidence-Based and Problem Oriented. Munich: Zuckschwerdt; 2001.
Sohn TA, Yeo CJ. Pancreatic and periampullary Carcinoma (non endocrine). In: Pancreas. Ch. 5. Vol. 3. San Diego, CA: Elsevier Health; 2004.
Hatzarus I, George N, Muscarella P, et al. Predictors of survival in periampullary cancers following pancreaticoduodenectomy. Ann Surg Oncol 2010;17:991-7.
Jagannath P, Shrikhande S. Current options in the diagnosis and management of periampullary carcinoma. Indian J Surg 2003;65:347-53.
Pancreatric Section, British Society of Gastroenterology, Pancreatic Society of Great Britain and Ireland, Association of Upper Gastrointestinal Surgeons of Great Britain and Ireland, Royal College of Pathologists, Special Interest Group for Gastro-Intestinal Radiology. Guidelines for the management of patients with pancreatic cancer periampullary and ampullary carcinomas. Gut 2005;54 Suppl 5:51-16.
Soldik Z, Zitnjak D, Bolanca A, et al. Long-time survival of a patient with metastatic pancreatic cancer: A case report. Case Rep Oncol 2011;4:367-70.
Klein F, Jacob D, Bahra M, et al. Prognostic factors for long-term survival in patients with ampullary carcinoma: The results of a 15 year observation period after pancreaticoduodenectomy. HPB Surg 2014;2014:970234.
Kuvshinoff BW, Bryer MP. Treatment of resectable and locally advanced pancreatic cancer. Cancer Control 2000;7:428-36.
El Kamar FG, Grossbard ML, Kozuch PS. Metastatic pancreatic cancer: Emerging strategies in chemotherapy and palliative care. Oncologist 2003;8:18-34.
Seufferlein T, Bachet JB, Cutsem EV, et al. Pancreatic adenocarcinoma: ESMO-ESDO clinical practice guidelines for diagnosis, treatment and follow up. Ann Oncol 2012;23:733-40
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