{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,6,3]],"date-time":"2025-06-03T16:29:36Z","timestamp":1748968176955,"version":"3.41.0"},"reference-count":0,"publisher":"International Institute of Anticancer Research","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["CDP"],"published-print":{"date-parts":[[2025,5,3]]},"abstract":"<jats:p>Background\/Aim:\nPeritoneal carcinomatosis is the end stage for patients with gastrointestinal cancer, with survival ranging between 2 and 9 months. Pancreatic acinar cell carcinoma (PACC) is rare and can result in peritoneal metastases. The efficacy of chemotherapy for patients with PACC is unknown, and a systemic treatment strategy has not been established. The aim of the present perspective is to discuss a potential curative strategy combining surgery, heated intraperitoneal chemotherapy (HIPEC), and the histoculture drug response assay (HDRA) to identify effective adjuvant chemotherapy for PACC with peritoneal metastases, based on a published case report.\nCase Report:\nA 31-year-old man with a 20 cm epigastric mass, diagnosed as PACC, had curative-intent resection of a tumor on the distal stomach and pancreas tail. The patient recurred after four courses of adjuvant oral S-1 treatment. Laparotomy demonstrated peritoneal metastases with a peritoneal cancer index of 18. Ascites or other cancer cells in the peritoneal wash were not found. Peritonectomy, combined with HIPEC with gemcitabine and docetaxel, was performed intraoperatively. Postoperative 3-dimensional histoculture of fragments of the resected tumor with drug response testing with the histoculture drug response assay (HDRA) showed gemcitabine had the highest tumor inhibitory rate (70%) among six drugs tested. Based on the HDRA results, the patient was treated with adjuvant systemic gemcitabine chemotherapy. The patient did not have a recurrence within 18 months after surgery.\nConclusion:\nThe present innovative treatment of PACC with peritoneal metastases used laparotomy to determine the extent of peritoneal metastases, peritonectomy to attempt to completely remove the tumor, HIPEC for intraoperative hyperthermic-chemotherapy, and the HDRA to determine the most effective drug for adjuvant chemotherapy. These procedures can be individualized for each patient's cancer, and the HDRA is most critical for individualization.<\/jats:p>","DOI":"10.21873\/cdp.10440","type":"journal-article","created":{"date-parts":[[2025,5,7]],"date-time":"2025-05-07T13:22:31Z","timestamp":1746624151000},"page":"280-284","source":"Crossref","is-referenced-by-count":0,"title":["Perspective on an Innovative Curative Strategy for Peritoneal Metastasis Involving Peritonectomy, Hyperthermic Intraperitoneal Chemotherapy, and Adjuvant Chemotherapy Identified as Effective in the Histoculture Drug Response Assay (HDRA)"],"prefix":"10.21873","volume":"5","author":[{"given":"YOHEI","family":"ASANO","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"YUTAKA","family":"YONEMURA","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"CHIHIRO","family":"HOZUMI","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"KOHEI","family":"MIZUTA","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"BYUNG MO","family":"KANG","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"JIN SOO","family":"KIM","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"NORIO","family":"YAMAMOTO","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"KATSUHIRO","family":"HAYASHI","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"HIROAKI","family":"KIMURA","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"SHINJI","family":"MIWA","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"KENTARO","family":"IGARASHI","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"TAKASHI","family":"HIGUCHI","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"SEI","family":"MORINAGA","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"HIROYUKI","family":"TSUCHIYA","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"SATORU","family":"DEMURA","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"ROBERT M.","family":"HOFFMAN","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"9336","published-online":{"date-parts":[[2025,5,3]]},"container-title":["Cancer Diagnosis &amp; Prognosis"],"original-title":[],"deposited":{"date-parts":[[2025,5,7]],"date-time":"2025-05-07T13:22:32Z","timestamp":1746624152000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cancerdiagnosisprognosis.org\/article\/494\/perspective-on-an-innovative-curative-strategy-for-peritoneal-metastasis-involving-peritonectomy-hyperthermic-intraperitoneal-chemotherapy-and-adjuvant-chemotherapy-identified-as-effective-in-the-histoculture-drug-response-assay-hdra"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,3]]},"references-count":0,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2025,5,3]]},"published-print":{"date-parts":[[2025,5,3]]}},"URL":"https:\/\/doi.org\/10.21873\/cdp.10440","relation":{},"ISSN":["2732-7787"],"issn-type":[{"type":"print","value":"2732-7787"}],"subject":[],"published":{"date-parts":[[2025,5,3]]}}}