# Successful Multimodal Treatment of Pancreatic Cancer With Extensive Superior Mesenteric Vein Thrombosis Utilizing Chemotherapy Combined With Direct Oral Anticoagulant

## TL;DR

A pancreatic cancer patient with vein clot was successfully treated with chemotherapy and blood thinners, allowing surgery and long-term survival.

## Contribution

A successful multimodal treatment approach for pancreatic cancer with vein thrombosis using chemotherapy and anticoagulants is reported.

## Key findings

- Combination therapy led to disappearance of the thrombus and tumor shrinkage.
- Curative surgery became possible after treatment, resulting in over five years of survival.
- The case suggests a potential treatment option for borderline resectable pancreatic cancer with vein thrombosis.

## Abstract

It is well known that portal vein thrombosis (PVT) sometimes occurs in pancreatic cancer (PC). However, no effective treatment plan for PVT in PC patients has yet been proposed. We experienced a successfully treated case of borderline resectable pancreatic cancer (PC-BR) with extensive superior mesenteric vein thrombosis utilizing intensive chemotherapy combined with direct oral anticoagulant. The thrombus disappeared and the tumor shrank, enabling curative surgery, and long-term survival for more than five years has been achieved. We report this successful case that we experienced as an option for the treatment of PC-BR with PVT in the future era when multimodal treatment is important.