{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T19:38:31Z","timestamp":1770061111349,"version":"3.49.0"},"reference-count":17,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2022,12,27]],"date-time":"2022-12-27T00:00:00Z","timestamp":1672099200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,12,27]],"date-time":"2022-12-27T00:00:00Z","timestamp":1672099200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["surg case rep"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Preoperative treatment is performed for locally advanced colon cancer with extensive tumor proximity or suspected invasion of skeletal muscles, major organs, and blood vessels. Oxaliplatin-based regimens are often used in preoperative chemotherapy. However, microsatellite instability (MSI)-high colorectal cancer is often resistant to cytotoxic anticancer agents. Herein, we describe a case of treatment of anticancer drug-resistant MSI-high locally advanced colon cancer and review cases of complete response to immune checkpoint inhibitor therapy for colorectal cancer.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>A 57-year-old woman was referred to our hospital with a large tumor in the descending colon and extensive thoracic and abdominal wall involvement, including the ribs and diaphragm. No distant metastasis was observed. The tumor had perforated the abdominal wall and formed an abscess. Upon visiting our hospital, emergency surgery was performed. An abdominal wall incision was made to drain the abscess and laparoscopic colostomy was performed. Histopathological examination of biopsy specimens revealed an adenocarcinoma with positive immunohistochemical expressions of both CDX2 and CK20. The patient was diagnosed with a descending colon cancer. Genetic examination found MSI-high, Kras mutation (F12G), and wild-type BRAF. After the inflammation improved, chemotherapy with the FOLFIRI regimen was initiated, but the tumor grew rapidly. As a second-line treatment, nivolumab and ipilimumab combination therapy was initiated. After four cycles of these therapies, the patient was administered nivolumab alone for five cycles. Tumor shrinkage was observed and radical surgery was performed. The patient underwent laparoscopic descending colon and partial thoracic and abdominal wall resection. The abdominal wall muscle was dissected from the abdominal cavity, and subcutaneous tissues, diaphragm, ribs were dissected from the body surface. Pathological examination revealed mucus components, fibrous tissues, and no malignant cells, indicating a complete pathological response (pCR). The patient had a good postoperative course and returned to work after being discharged. No recurrence was observed six months postoperatively.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Herein, we report a case of anticancer drug-resistant MSI-high colon cancer that was resected after treatment with immune checkpoint inhibitors, and a pCR was achieved. This new treatment strategy can be used for the treatment of cases that are not responsive to conventional therapies.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s40792-022-01580-w","type":"journal-article","created":{"date-parts":[[2022,12,27]],"date-time":"2022-12-27T09:03:14Z","timestamp":1672131794000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Pathologic complete response after laparoscopic surgery following treatment with nivolumab and ipilimumab for anticancer drug-resistant MSI-high descending colon cancer: a case report and literature review"],"prefix":"10.1186","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0082-7601","authenticated-orcid":false,"given":"Hiroshi","family":"Sawayama","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuji","family":"Miyamoto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katsuhiro","family":"Ogawa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mayuko","family":"Ohuchi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuki","family":"Hisano","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Moeko","family":"Kato","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroki","family":"Tubakihara","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naoya","family":"Yoshida","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hideo","family":"Baba","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2022,12,27]]},"reference":[{"issue":"6","key":"1580_CR1","doi-asserted-by":"publisher","first-page":"1357","DOI":"10.1111\/codi.15585","volume":"23","author":"M Karoui","year":"2021","unstructured":"Karoui M, Gallois C, Piessen G, Legoux JL, Barbier E, De Chaisemartin C, et al. Does neoadjuvant FOLFOX chemotherapy improve the prognosis of high-risk Stage II and III colon cancers? Three years\u2019 follow-up results of the PRODIGE 22 phase II randomized multicentre trial. Colorectal Dis. 2021;23(6):1357\u201369.","journal-title":"Colorectal Dis"},{"issue":"23","key":"1580_CR2","doi-asserted-by":"publisher","first-page":"2207","DOI":"10.1056\/NEJMoa2017699","volume":"383","author":"T Andre","year":"2020","unstructured":"Andre T, Shiu KK, Kim TW, Jensen BV, Jensen LH, Punt C, et al. Pembrolizumab in microsatellite-instability-high advanced colorectal cancer. N Engl J Med. 2020;383(23):2207\u201318.","journal-title":"N Engl J Med"},{"issue":"2","key":"1580_CR3","doi-asserted-by":"publisher","first-page":"161","DOI":"10.1200\/JCO.21.01015","volume":"40","author":"HJ Lenz","year":"2022","unstructured":"Lenz HJ, Van Cutsem E, Luisa Limon M, Wong KYM, Hendlisz A, Aglietta M, et al. First-line nivolumab plus low-dose ipilimumab for microsatellite instability-high\/mismatch repair-deficient metastatic colorectal cancer: the phase ii checkmate 142 study. J Clin Oncol. 2022;40(2):161\u201370.","journal-title":"J Clin Oncol"},{"issue":"1","key":"1580_CR4","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1093\/jjco\/hyaa200","volume":"51","author":"H Hirano","year":"2021","unstructured":"Hirano H, Takashima A, Hamaguchi T, Shida D, Kanemitsu Y, Colorectal Cancer Study Group of the Japan Clinical Oncology G. Current status and perspectives of immune checkpoint inhibitors for colorectal cancer. Jpn J Clin Oncol. 2021;51(1):10\u20139.","journal-title":"Jpn J Clin Oncol"},{"issue":"5","key":"1580_CR5","doi-asserted-by":"publisher","first-page":"528","DOI":"10.1002\/ags3.12362","volume":"4","author":"H Sawayama","year":"2020","unstructured":"Sawayama H, Miyamoto Y, Ogawa K, Yoshida N, Baba H. Investigation of colorectal cancer in accordance with consensus molecular subtype classification. Ann Gastroenterol Surg. 2020;4(5):528\u201339.","journal-title":"Ann Gastroenterol Surg"},{"issue":"5","key":"1580_CR6","doi-asserted-by":"publisher","first-page":"275","DOI":"10.1038\/nrc.2016.36","volume":"16","author":"SL Topalian","year":"2016","unstructured":"Topalian SL, Taube JM, Anders RA, Pardoll DM. Mechanism-driven biomarkers to guide immune checkpoint blockade in cancer therapy. Nat Rev Cancer. 2016;16(5):275\u201387.","journal-title":"Nat Rev Cancer"},{"issue":"25","key":"1580_CR7","doi-asserted-by":"publisher","first-page":"2363","DOI":"10.1056\/NEJMoa2201445","volume":"386","author":"A Cercek","year":"2022","unstructured":"Cercek A, Lumish M, Sinopoli J, Weiss J, Shia J, Lamendola-Essel M, et al. PD-1 blockade in mismatch repair-deficient, locally advanced rectal cancer. N Engl J Med. 2022;386(25):2363\u201376.","journal-title":"N Engl J Med"},{"issue":"7","key":"1580_CR8","doi-asserted-by":"publisher","first-page":"798","DOI":"10.6004\/jnccn.2020.7558","volume":"18","author":"R Demisse","year":"2020","unstructured":"Demisse R, Damle N, Kim E, Gong J, Fakih M, Eng C, et al. Neoadjuvant immunotherapy-based systemic treatment in MMR-deficient or MSI-high rectal cancer: case series. J Natl Compr Canc Netw. 2020;18(7):798\u2013804.","journal-title":"J Natl Compr Canc Netw"},{"issue":"1","key":"1580_CR9","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1186\/s12876-021-02084-x","volume":"22","author":"M Tonello","year":"2022","unstructured":"Tonello M, Nappo F, Vassallo L, Di Gaetano R, Davoli C, Pizzolato E, et al. Complete pathological response of colorectal peritoneal metastases in Lynch syndrome after immunotherapy case report: is a paradigm shift in cytoreductive surgery needed? BMC Gastroenterol. 2022;22(1):17.","journal-title":"BMC Gastroenterol"},{"issue":"6","key":"1580_CR10","doi-asserted-by":"publisher","first-page":"1552","DOI":"10.4103\/jcrt.jcrt_156_21","volume":"17","author":"AM Dhamani","year":"2021","unstructured":"Dhamani AM, Sheth HS, Bhattacharyya S, Shaikh IN. Paradigm shift from palliation to cure in metastatic microsatellite high colorectal carcinoma with immune checkpoint inhibitors. J Cancer Res Ther. 2021;17(6):1552\u20135.","journal-title":"J Cancer Res Ther"},{"issue":"12","key":"1580_CR11","doi-asserted-by":"publisher","first-page":"e2110","DOI":"10.1002\/onco.13955","volume":"26","author":"J Trojan","year":"2021","unstructured":"Trojan J, Stintzing S, Haase O, Koch C, Ziegler P, Demes M, et al. Complete pathological response after neoadjuvant short-course immunotherapy with ipilimumab and nivolumab in locally advanced MSI-H\/dMMR rectal cancer. Oncologist. 2021;26(12):e2110\u20134.","journal-title":"Oncologist"},{"key":"1580_CR12","doi-asserted-by":"publisher","first-page":"75","DOI":"10.1016\/j.ejca.2020.04.046","volume":"135","author":"L Mans","year":"2020","unstructured":"Mans L, Pezzullo M, D\u2019Haene N, Van de Stadt J, Van Laethem JL. Pathological complete response after neoadjuvant immunotherapy for a patient with microsatellite instability locally advanced rectal cancer: should we adapt our standard management for these patients? Eur J Cancer. 2020;135:75\u20137.","journal-title":"Eur J Cancer"},{"issue":"12","key":"1580_CR13","doi-asserted-by":"publisher","DOI":"10.1080\/2162402X.2019.1663108","volume":"8","author":"J Zhang","year":"2019","unstructured":"Zhang J, Cai J, Deng Y, Wang H. Complete response in patients with locally advanced rectal cancer after neoadjuvant treatment with nivolumab. Oncoimmunology. 2019;8(12): e1663108.","journal-title":"Oncoimmunology"},{"issue":"2","key":"1580_CR14","first-page":"115","volume":"36","author":"MS Copur","year":"2022","unstructured":"Copur MS, Schroeder CW, Ly Q, Wedel W, Kelly JR, Rodriguez P, et al. Complete pathologic response to neoadjuvant chemoimmunotherapy and oxaliplatin-induced fever associated with il-6 release in a patient with locally advanced colon cancer. Oncology (Williston Park). 2022;36(2):115\u20139.","journal-title":"Oncology (Williston Park)"},{"issue":"1","key":"1580_CR15","doi-asserted-by":"publisher","first-page":"134","DOI":"10.1007\/s12328-021-01543-y","volume":"15","author":"T Tominaga","year":"2022","unstructured":"Tominaga T, Nonaka T, Fukuda A, Moriyama M, Oyama S, Ishii M, et al. Pathological complete response to pembrolizumab in patients with metastatic ascending colon cancer with microsatellite instability. 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Clin Colorectal Cancer. 2018;17(2):e229\u201332.","journal-title":"Clin Colorectal Cancer"}],"container-title":["Surgical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40792-022-01580-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s40792-022-01580-w\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40792-022-01580-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,1,3]],"date-time":"2023-01-03T16:18:17Z","timestamp":1672762697000},"score":1,"resource":{"primary":{"URL":"https:\/\/surgicalcasereports.springeropen.com\/articles\/10.1186\/s40792-022-01580-w"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12,27]]},"references-count":17,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2022,12]]}},"alternative-id":["1580"],"URL":"https:\/\/doi.org\/10.1186\/s40792-022-01580-w","relation":{},"ISSN":["2198-7793"],"issn-type":[{"value":"2198-7793","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,12,27]]},"assertion":[{"value":"22 May 2022","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 December 2022","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 December 2022","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consents for the procedure and publication of this case report and any accompanying images were obtained from the patient.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"There are no conflicts of interest.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"223"}}