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A 60-year-old woman developed metachronous hepatic lesions after distal pancreatectomy, received sequential chemotherapy with gemcitabine plus nab-paclitaxel, and underwent three hepatectomies combined with radiofrequency ablation across different liver segments. Multidisciplinary therapy enabled survival beyond eight years with no evidence of disease.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/an-8-year-survivor-after-three-time-hepatectomies-for-metachronous-pancreatic-adenocarcinoma-liver-metastases-case-report/455412/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/an-8-year-survivor-after-three-time-hepatectomies-for-metachronous-pancreatic-adenocarcinoma-liver-metastases-case-report/455412.png","ImageObject",300,407,{"name":42,"@type":43},"MrHarris58","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-10-30","2026-09-30",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",10,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"Why are operative indications for metachronous liver metastases in PDAC limited?","Question",{"text":63,"@type":64},"Recurrence of PDAC after primary resection is challenging, and the document notes that operative indications for metachronous liver metastases are limited.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"What treatments were used for the patient’s liver metastases?",{"text":68,"@type":64},"After chemotherapy with gemcitabine plus nab-paclitaxel, the patient underwent partial liver resections and radiofrequency ablation (RFA) across liver segments for separate metastatic episodes.",{"name":70,"@type":61,"acceptedAnswer":71},"How long did the patient survive after the initial pancreatic surgery?",{"text":72,"@type":64},"More than eight years have passed since the initial pancreatectomy, and she is currently alive without disease.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},455412,1790937210,{"code":4,"msg":82,"data":83},"success",[84,88,92,96,101,106,110,115,120,123,126],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":89,"show_sort_weight":90,"slug":91},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":93,"show_sort_weight":94,"slug":95},"Exam",70,"exam",{"id":97,"doc_module":4,"doc_module_name":25,"category_name":98,"show_sort_weight":99,"slug":100},5,"Comic",60,"comic",{"id":102,"doc_module":4,"doc_module_name":25,"category_name":103,"show_sort_weight":104,"slug":105},6,"Technology",50,"technology",{"id":107,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":108,"slug":109},7,40,"healthcare",{"id":111,"doc_module":4,"doc_module_name":25,"category_name":112,"show_sort_weight":113,"slug":114},8,"Research & Report",30,"research-report",{"id":116,"doc_module":4,"doc_module_name":25,"category_name":117,"show_sort_weight":118,"slug":119},9,"Religion & Spirituality",20,"religion-spirituality",{"id":118,"doc_module":4,"doc_module_name":25,"category_name":121,"show_sort_weight":118,"slug":122},"World Cup","world-cup",{"id":55,"doc_module":4,"doc_module_name":25,"category_name":124,"show_sort_weight":55,"slug":125},"Lifestyle","lifestyle",{"id":127,"doc_module":4,"doc_module_name":25,"category_name":128,"show_sort_weight":97,"slug":129},19,"General","general",{"code":4,"msg":82,"data":131},{"doc_id":79,"user_id":132,"nickname":42,"user_avatar":133,"doc_module":4,"category_id":107,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":111,"language":139,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":12,"update_tm":143,"read_time":118,"preview_page_count":4},687212988360,"https://ap-avatar.wpscdn.com/davatar_276721f389ce27ea32af1340a28f341c","SURGICAL CASE REPORTS Surg Case Rep 2026; 12: 25-0242  \nCase Report  \nAn 8-Year Survivor after Three-Time Hepatectomies for Metachronous Pancreatic Adenocarcinoma  \nLiver Metastases  \nToshiro Masuda,1,2 Hirohisa Okabe,1 Takeshi Morinaga,1 Naoki Umezaki,1 Hidetoshi Nitta,1 Masahiko Hirota,1 Ryoichi Kurano,3 Toru Beppu,2 and Hiroki Sugita1  \nABSTRACT  \nINTRODUCTION: Recurrence of pancreatic ductal adenocarcinoma (PDAC) after primary resection remains a challenging condition, and operative indications for metachronous liver metastases are limited.  \nCASE PRESENTATION: A 60-year-old woman with no elevation of carcinoembryonic antigen, carbohydrate antigen 19-9, and Duke pancreatic monoclonal antigen type 2 underwent a distal pancreatectomy for PDAC. Two years and 4 months after the primary surgery, metachronous liver metastases in liver segments 4 and 5 were diagnosed. After receiving 8 courses of bi-weekly gemcitabine plus nab-paclitaxel, a partial liver resection of segment 5 with radiofrequency ablation (RFA) of segment 4 was performed. A laparoscopic partial liver resection of segment 8 was performed for another liver metastasis 5 years and 2 months after the primary resection. An open partial liver resection of segment 8 was performed for the liver recurrence adjacent to the previous resection area 7 years and 2 months after the initial pancreatectomy. More than 8 years have passed since the initial pancreatic surgery, and she is currently alive without disease. CONCLUSION: Multidisciplinary treatment, including chemotherapy, resection, and RFA, may increase survival time in selected PDAC patients.  \nKEYWORDS: pancreatic ductal adenocarcinoma, liver metastasis, liver resection  \nAbbreviations  \nCA19-9 carbohydrate antigen 19-9  \nCEA carcinoembryonic antigen  \nDUPAN-2 Duke pancreatic monoclonal antigen type 2  \n1Department of Surgery, Kumamoto Regional Medical Center, Kumamoto, Kumamoto, Japan  \n2Department of Surgery, Yamaga City Medical Center, Yamaga, Kumamoto, Japan  \n3Department of Pathology, Kumamoto Regional Medical Center, Kumamoto, Kumamoto, Japan  \nCorresponding author: Toshiro Masuda. Department of Surgery, Yamaga City Medical Center, 511 Yamaga, Yamaga, Kumamoto 860-0593, Japan  \n[E-mail: masuda1046@yahoo.co.jp](E-mail: masuda1046@yahoo.co.jp)  \nReceived: July 23, 2025; Accepted: December 7, 2025  \nDOI: 10.70352/scrj.cr.25-0242  \n Supplementary materials are available online.  \nPDAC pancreatic ductal adenocarcinoma  \nRFA radiofrequency ablation  \nINTRODUCTION  \nRecurrence of pancreatic ductal adenocarcinoma (PDAC) after primary resection remains a challenging condition, and chemotherapy is mostly considered to be the first choice for treatment. 1–3) Patients with isolated metachronous lung oligometastases are reportedly good candidates for surgical resection.4–6) However, the operative indication for metachronous liver metastases is limited.2,7) According to a review article on surgically treated PDAC patients with metachronous liver metastases, the median interval from pancreas surgery to hepatectomy, overall survival after hepatectomy, and overall survival after initial pancreatectomy were 7.6 to 18.4, 11.4 to 31.0, and 24.5 to 40 months, respectively.8)  \n© 2026 The Author(s) . Published by Japan Surgical Society  \nThis article is licensed under a Creative Commons Attribution 4.0 International License.  \nMasuda T. et al.  \n0 1 2 3 4 5 6 7 8 (years)  \n4 years CEA (ng/mL)  \n10  \n1 year and 2 years  \n2 months  \nFig. 1 Clinical treatment course and the changes of tumor markers of the current patient.  \nCA19-9, carbohydrate antigen 19-9; CEA, carcinoembryonic antigen 19-9; GEM, gemcitabine; nabPTX, nab-paclitaxel; RFA, radiofrequency ablation  \n-2015 -2015 -2015 -2016 -2016 -2016 -2016 -2016 -2016 -2017 -2017 -2017 -2017 -2017 -2017 -2018 -2018 -2018 -2018 -2018 -2018 -2019 -2019 -2019 -2019 -2019 -2019 -2020 -2020 -2020 -2020 -2020 -2020 -2021 -2021 -2021 -2021 -2021 -2021 -2022 -2022 -2022 -2022 -2022 -2022 -2023 -","cbCaigxmFHftGl73","https://ap.wps.com/l/cbCaigxmFHftGl73","pdf",3864111,"English","# Abstract\n# Introduction\n# Case presentation\n# Conclusion\n# Keywords","[{\"question\":\"Why are operative indications for metachronous liver metastases in PDAC limited?\",\"answer\":\"Recurrence of PDAC after primary resection is challenging, and the document notes that operative indications for metachronous liver metastases are limited.\"},{\"question\":\"What treatments were used for the patient’s liver metastases?\",\"answer\":\"After chemotherapy with gemcitabine plus nab-paclitaxel, the patient underwent partial liver resections and radiofrequency ablation (RFA) across liver segments for separate metastatic episodes.\"},{\"question\":\"How long did the patient survive after the initial pancreatic surgery?\",\"answer\":\"More than eight years have passed since the initial pancreatectomy, and she is currently alive without disease.\"}]","An 8-Year Survivor after Three-Time Hepatectomies for Metachronous Pancreatic Adenocarcinoma Liver Metastases - Case Report | PDF",1790742810]