Pancreatic cancer often presents insidiously, making early diagnosis challenging. The disease typically progresses rapidly, with a short survival time for patients and poor prognosis, earning it the title of “king of cancers”. 

Recently, a special patient visited the Department of Hepatobiliary and Pancreatic Surgery at the Second Affiliated Hospital Zhejiang University School of Medicine. Seventy-four-year-old Ms. Chen (a pseudonym) walked in without difficulty, accompanied by her daughter-in-law. Her smile conveyed her inner joy as she repeatedly expressed her gratitude.

In the first six months of last year, Ms. Chen was diagnosed with locally-advanced pancreatic cancer. Professor Yan Sheng’s team carefully evaluated Ms. Chen’s condition and, based on her examination and test results, developed a treatment plan that included neoadjuvant therapy followed by surgery. Six months later, Ms. Chen finally had the opportunity to undergo a curative surgical resection.

On September 12, 2023, Professor Yan’s surgical team performed a total pancreatectomy on Ms. Chen. Additionally, autologous islet isolation and reinfusion were carried out using the negative-margin pancreatic body and tail tissue. After her surgery, Ms. Chen recovered well, and her fasting C-peptide level had returned to 0.18 U/L at discharge, indicating that her islets were starting to survive and function.

During the year-long follow-up after her discharge, Ms. Chen continued with routine chemotherapy but didn’t really suffer from hypoglycemia. She could enjoy her daily meals and engage in light physical activities, and was well-nourished and in a good physical condition.

Similarly, 53-year-old Ms. Mao (a pseudonym) was also diagnosed with locally-advanced pancreatic cancer, which invaded and encased the superior mesenteric artery and vein, making surgery highly challenging. After six months of neoadjuvant treatment at her local hospital, Ms. Mao visited Professor Yan’s clinic for a surgical evaluation.

Following a thorough preoperative assessment, on November 1, 2023, Professor Yan performed a total pancreatectomy with resection and reconstruction of the portal vein, along with autologous islet transplantation for Ms. Mao. Remarkably, during her hospitalization and after being discharged, Ms. Mao managed to maintain stable blood glucose levels without requiring insulin or any other hypoglycemic medications. Her blood glucose fluctuations remained minimal, and consistently within a relatively normal range. At the follow-up on the 321st postoperative day, Ms. Mao’s fasting blood glucose was 4.74 mmol/L, her fasting C-peptide was 0.19 nmol/L, and her 2-hour postprandial C-peptide was 1.6 nmol/L. Her glycated hemoglobin (HbA1c) was 5.8%, and her tumor marker CA 19-9 lay within the normal range. By this point, she had been living tumor-free for nearly a year while enjoying an excellent quality of life.

Wang Weilin, President of the Second Affiliated Hospital and the head of the Department of Hepatobiliary and Pancreatic Surgery, noted that the total pancreatectomy with autologous islet transplantation performed by Professor Yan’s team has significantly improved the quality of life of pancreatic cancer patients with better nutrition and a stronger physical condition. This approach can even lead to insulin independence, extend tumor-free survival, reduce surgical complications, and increase the postoperative survival rates, thus laying a solid foundation for prolonging patients’ survival time, and so markedly improving the treatment outcomes for pancreatic cancer surgeries.