Resection for pancreatic cancer metastases contributes to survival: A case report with sequential tumor genotype profiling during the long-term postoperative course
Resection for pancreatic cancer metastases contributes to survival: A case report with sequential tumor genotype profiling during the long-term postoperative course
复制标题
胰腺癌转移切除有助于生存：长期术后过程中连续肿瘤基因型分析的病例报告
DOI：
10.1097/md.0000000000020564
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发表时间：
2020
期刊：
影响因子：
--
通讯作者：
Okumura T.
中科院分区：
文献类型：
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作者：
Sato H;Sasajima J;Okada T;Hayashi A;Kawabata H;Goto T;Koizumi K;Tamamura N;Tanabe H;Fujiya M;Chiba S;Tanino M;Ono Y;Mizukami Y;Okumura T.
干预措施：患者行胰腺远端切除术，病理检查显示为管状腺癌。单独的肝和肺转移瘤分别在首次出现6个月和43个月后被发现，并进行了连续的转移切除。结果：患者在初次就诊后存活了8年。切除标本、原发性PDA以及肝脏和肺部复发肿瘤的遗传谱在密码子12处具有相同的KRAS突变，而主要肿瘤抑制基因如TP53、CDKN2A和SMAD4没有突变。基于多重聚合酶链反应的微卫星不稳定性试验证明了微卫星的稳定性。结论：本病例患者在原发肿瘤切除和异时转移性肿瘤切除后存活超过8年。PDA的结果可能与调节其生物学行为的遗传谱有关。孤立性转移瘤的手术治疗可能是胰腺癌患者的一种治疗选择。
Interventions:The patient underwent distal pancreatectomy, and pathological examination revealed a tubular adenocarcinoma. Solitary liver and lung metastatic tumors were found 6 and 43 months after the initial presentation, respectively, and sequential metastasectomies were performed.Outcomes:The patient survived until 8 years after her initial presentation. The genetic profiles of the resected specimens, primary PDA, and recurrent tumors in the liver and lung possessed identical KRAS mutations at codon 12, whereas there were no mutations in the main tumor suppressor genes, such as TP53, CDKN2A, and SMAD4. Multiplex polymerase chain reaction-based microsatellite instability assay demonstrated microsatellite stability.Conclusion:In our case, the patient with pancreatic adenocarcinoma survived for over 8 years following the resection of the primary tumor and resections of metachronous metastatic tumors. The outcome of PDA may be associated with the genetic profile that regulates its biological behavior. Operative management of solitary metastatic tumors may be a therapeutic options for selected patients with pancreatic cancer.