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. 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. 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.

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寻找新型的多模式治疗胰腺转移性胰腺癌

即使采用化学疗法治疗，转移性胰腺癌的平均总生存期仍少于12个月。选定的少转移性疾病患者可受益于化学疗法，手术疗法或转移灶的射频消融（RFA）的多模式治疗。我们介绍了一种多转移性胰腺癌治疗成功的少转移胰腺癌患者。最初表现为可切除的胰腺癌的57岁男性接受了胰十二指肠切除术。组织病理学诊断显示导管胰腺癌，手术切除切缘阳性，淋巴结阴性。他完成了吉西他滨（1000 mg / mq 1,8,15qq 28）的六个辅助治疗周期，然后每周两次与吉西他滨50 mg / mq相关的外部放疗（54 Gy，分25步）。三年后，患者发生了多个肝转移，他开始进行FOLFIRINOX（奥沙利铂85 mg / mq，伊立替康180 mg / mq，亚叶酸400 mg / mq和氟尿嘧啶400 mg / mq推注，随后以2400 mg / mq推注）。一线治疗持续46小时，1q 14）。6个循环后，CT扫描显示部分反应。经过多学科讨论后，患者接受了三个肝病灶的腹腔镜转移术。在进行了4个周期的FOLFIRINOX方案的其他术后化疗后，患者保持了12个月的无复发。CT扫描显示有新的单一肝转移，并用射频消融（RFA）治疗。当患者在第一次RFA后12个月又出现了另一个肝病灶时，进行了第二次射频消融。目前，该患者自诊断以来无复发，总生存期为6年。我们的病例受益于成功的多模式治疗，包括外科手术和局部消融技术以及全身化疗。某些转移性胰腺癌患者可能需要采取多模式方法，并且可以改善总体生存率。需要进一步研究以研究这种方法。包括外科手术和局部消融技术以及全身化疗。某些转移性胰腺癌患者可能需要采取多模式方法，并且可以改善总体生存率。需要进一步研究以研究这种方法。包括外科手术和局部消融技术以及全身化疗。某些转移性胰腺癌患者可能需要采取多模式方法，并且可以改善总体生存率。需要进一步研究以研究这种方法。