En-bloc pancreatoduodenectomy and right hemicolectomy for treating locally advanced right colon cancer (T4): a series of five patients

Abstract

A series of five cases of right-colon adenocarcinoma that invaded the proximal duodenum is presented. All patients underwent successful en-bloc pancreatoduodenectomy plus right hemicolectomy by General Surgery Service of the Teaching Hospital of the ABC Medical School, Santo André, SP, Brazil. The study was conducted between 2000 and 2007. There were two major complications but no mortality. Three patients did not present any recurrence over the course of 15 to 54 months of follow-up. Multivisceral resection with en-bloc pancreatoduodenectomy should be considered for patients who are fit for major surgery but do not present distant dissemination. Long-term survival may be attained.

Resection for Secondary Malignancy of the Pancreas

“…8,9,108 For overall primary tumors, the median metastatic interval is 84 months (7 years) in this study. Particularly, RCC metastatic to the pancreas is very unique in that there is often a prolonged disease-free interval between nephrectomy and subsequent appearance of pancreatic metastases, with reported median periods of 7 to 10 years in literature 2,6,8,9,104,108 and 108 months (9 years) by this study, and as long as 28 years in 1 case to the recognition of metastatic disease. 8,9,108 Positive rate of lymph node metastasis is higher from to 91.3% in RCC metastasis and 88.2% in overall primary tumors, in comparison to 52.9% in colon cancer and 21.9% of stomach cancer with local invasion to the pancreas.…”

“…15 In cases of colon cancer that adheres to adjacent structures, a local treatment failure rate was reported up from 36% to 53% following complete resection. 2,15 In such cases, curative surgery with extended or multivisceral resection might be the treatment of choice. 2,15 In fact, metastatic disease or extensive invasion to the pancreas is often associated with a terminal-stage condition, which precludes a major operation such as pancreatic surgery.…”

“…2,15 In such cases, curative surgery with extended or multivisceral resection might be the treatment of choice. 2,15 In fact, metastatic disease or extensive invasion to the pancreas is often associated with a terminal-stage condition, which precludes a major operation such as pancreatic surgery. 7 Currently, there is very limited experience with pancreatic resection of secondary malignancy in each literature report, and the role of surgery in the management of these patients has not been clearly defined.…”

Long term survival after right hemicolectomy and pancreatoduodenectomy for locally advanced colonic cancer: Case report

“…[2][3][4][5] In these cases there is a local treatment failure rate of 36-53% following complete resection. 6 Invasion of the duodenum or the head of the pancreas poses a rather challenging problem even to the skilled surgeon.…”

Tumor regression after neoadjuvant chemotherapy in locally advanced colon cancer

“…Часто опухоль враста-ет в смежные органы, в результате чего требуется их одновременное удаление. По данным различных авторов, резекции, выполненные в пределах здоровых тканей, уменьшают количество местных рецидивов и улучша-ют выживаемость пациентов [1][2][3]. Но даже при отри-цательном крае резекции прогрессирование рака после радикального лечения является актуальной и нерешен-ной проблемой, а механизмы, ответственные за эти процессы, остаются неясными.…”