scholarly journals Pathological Complete Response of Clinical T4b Ascending Colon Cancer after Preoperative Chemotherapy Using Pembrolizumab

2021 ◽  
pp. 1497-1504
Author(s):  
Terufumi Yoshida ◽  
Hisanori Miki ◽  
Hironaga Satake ◽  
Toshinori Kobayashi ◽  
Yuuki Matsumi ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Lymph Node ◽  
Preoperative Chemotherapy ◽  
Pathological Complete Response ◽  
Complete Response ◽  
Resected Specimen ◽  
Preoperative Treatment ◽  
Ascending Colon ◽  
Ascending Colon Cancer ◽  
Iliacus Muscle

Preoperative chemotherapy is efficacious in several cancers. However, it is not an established treatment for locally advanced colon cancer, particularly cases with microsatellite instability-high (MSI-H)/deficient mismatch repair. Herein, we report a case of pathological complete response of MSI-H clinical T4b ascending colon cancer to preoperative treatment with pembrolizumab. A 78-year-old man was diagnosed with ascending colon cancer that invaded into the iliacus muscle and enlarged regional lymph nodes. The tumor was classified as T4bN1bM0 stage IIIC according to the 8th Union for International Cancer Control guidelines, with MSI-H status. Based on our initial diagnosis, this tumor could not be resected completely. Thus, the patient underwent preoperative therapy with CAPOX (capecitabine and oxaliplatin combination) plus bevacizumab. After 4 cycles of preoperative CAPOX/bevacizumab, we observed tumor reduction corresponding to a partial response based on the Response Evaluation Criteria in Solid Tumors criteria. Nevertheless, tumor invasion of the iliacus muscle persisted. Since oxaliplatin-induced peripheral sensory neuropathy was observed, we discontinued treatment with oxaliplatin and changed the regimen to pembrolizumab in anticipation of the therapeutic effect of this immune checkpoint inhibitor against MSI-H tumors. After 2 cycles of therapy with pembrolizumab (200 mg/body on day 1 every 3 weeks), there was drastic tumor regression. In addition, computed tomography indicated that all lymph node metastases had disappeared. Therefore, the patient underwent laparoscopic right hemicolectomy with D3 lymph node dissection. Analysis of the resected specimen showed pathological complete response.

scholarly journals Ascending colon cancer with synchronous right external iliac lymph node metastasis

2020 ◽  
Vol 9 (3) ◽  
pp. 162-167
Author(s):  
Yoshinori Iwata ◽  
Nobuhisa Matsuhashi ◽  
Takao Takahashi ◽  
Tomonari Suetsugu ◽  
Masahiro Fukada ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Ascending Colon ◽  
Node Metastasis ◽  
Iliac Lymph Node ◽  
Ascending Colon Cancer

scholarly journals A Case of Isolated Right External Iliac Lymph Node Recurrence from a Primary Ascending Colon Cancer

2013 ◽  
Vol 46 (9) ◽  
pp. 686-691
Author(s):  
Tetsunobu Udaka ◽  
Sumiharu Yamamoto ◽  
Izuru Endou ◽  
Masatoshi Kubo ◽  
Minoru Mizuta ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Lymph Node ◽  
Ascending Colon ◽  
Iliac Lymph Node ◽  
Lymph Node Recurrence ◽  
Ascending Colon Cancer

scholarly journals A Study of Lymph Node Metastasis of Ascending Colon Cancer.

1994 ◽  
Vol 47 (4) ◽  
pp. 331-335
Author(s):  
N. Sugihira ◽  
K. Matsumoto ◽  
T. Tada ◽  
I. Fujino ◽  
A. Okuda ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Ascending Colon ◽  
Node Metastasis ◽  
Ascending Colon Cancer

scholarly journals Laparoscopic ileo-transverse bypass may contribute to achieving curative resection for locally advanced right colon cancer: a case report

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Shunsuke Tabe ◽  
Toru Tonooka ◽  
Isamu Hoshino ◽  
Nobuhiro Takiguchi ◽  
Hiroaki Soda ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Case Report ◽  
Preoperative Chemotherapy ◽  
Transverse Colon ◽  
Curative Resection ◽  
Favorable Effect ◽  
Resected Specimen ◽  
Ascending Colon ◽  
Right Colon ◽  
Right Colon Cancer

Abstract Background The strategy for treating obstructive colon cancers with metastatic lesions remains unclear. Herein, we report a case of laparoscopic ileo-transverse colon bypass (LITB) before preoperative chemotherapy for an obstructive right colon cancer. Case presentation A 59-year-old woman was referred to our institution (Department of Gastroenterological Surgery, Chiba Cancer Center) for liver tumors detected on ultrasound. The clinical diagnosis was ascending colon cancer with multiple liver metastases. Based on the criteria of the International Union against Cancer Committee, 8th edition, the staging was confirmed as cT4aN1M1a(H), cStage IV. Although the primary tumor in the ascending colon extended beyond the colonic wall, curative resection was possible for both primary and metastatic tumors. We planned to administer chemotherapy before the radical surgery to obtain tumor-free resection margins; however, as the obstruction was fatal, LITB was prioritized and performed using five ports. An intracorporeal side-to-side anastomosis was performed between the ileum, 25 cm from the terminal ileum, and the transverse colon. The patient was discharged on postoperative day 18 without any complications. After LITB, for preoperative chemotherapy, five courses of capecitabine plus oxaliplatin (CapeOX) + bevacizumab were administered. Six weeks after the preoperative chemotherapy, right hemicolectomy with D3 lymph node dissection and right hepatectomy were performed. Pathological findings of the resected specimen confirmed curative resection of both lesions, and a favorable effect of chemotherapy was obtained. The patient has been alive for over 8 months after the surgery, with no evidence of cancer recurrence. Conclusions This case report demonstrates the effectiveness of LITB for obstructive right colon cancer in patients who need preoperative chemotherapy.

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