Pathological complete response of locally advanced colon cancer after preoperative radiotherapy: a case report and narrative review of the literature

Abstract Background The oncological effectiveness of preoperative radiotherapy for locally advanced colon cancer is unclear. We report a case of pathological complete response in a patient with locally advanced ascending colon cancer after preoperative radiotherapy following failure of chemotherapy....

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Main Authors: Sho Sekiya, Kiyotaka Imamura, Shintaro Takeuchi, Koichi Teramura, Yusuke Watanabe, Eiji Tamoto, Minoru Takada, Yoshihiro Kinoshita, Yoshiyasu Anbo, Fumitaka Nakamura, Nobuichi Kashimura, Hiroko Noguchi, Katsutoshi Miura, Satoshi Hirano
Format: Article
Language:English
Published: Japan Surgical Society 2018-06-01
Series:Surgical Case Reports
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Online Access:http://link.springer.com/article/10.1186/s40792-018-0466-8
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author Sho Sekiya
Kiyotaka Imamura
Shintaro Takeuchi
Koichi Teramura
Yusuke Watanabe
Eiji Tamoto
Minoru Takada
Yoshihiro Kinoshita
Yoshiyasu Anbo
Fumitaka Nakamura
Nobuichi Kashimura
Hiroko Noguchi
Katsutoshi Miura
Satoshi Hirano
author_facet Sho Sekiya
Kiyotaka Imamura
Shintaro Takeuchi
Koichi Teramura
Yusuke Watanabe
Eiji Tamoto
Minoru Takada
Yoshihiro Kinoshita
Yoshiyasu Anbo
Fumitaka Nakamura
Nobuichi Kashimura
Hiroko Noguchi
Katsutoshi Miura
Satoshi Hirano
author_sort Sho Sekiya
collection DOAJ
description Abstract Background The oncological effectiveness of preoperative radiotherapy for locally advanced colon cancer is unclear. We report a case of pathological complete response in a patient with locally advanced ascending colon cancer after preoperative radiotherapy following failure of chemotherapy. Case presentation A 65-year-old Japanese woman presented with malaise and hematochezia. A computed tomography (CT) revealed a tumor in the ascending colon which seemed to infiltrate the adjacent structures. She was diagnosed with locally advanced ascending colon cancer stages T4b, N2a, M0, and IIIC. We selected modified FOLFOX6 with panitumumab as neoadjuvant chemotherapy. However, we discontinued the chemotherapy after the 8th cycle because of disease progression and severe adverse effects. The patient then underwent radiotherapy of 60 Gy in 30 fractions, resulting in significant tumor size reduction. One month after the radiotherapy, we performed a right hemicolectomy with multivisceral resection without complications. Histopathologically, we found no residual cancer cells in the resected specimen. The patient remains alive and has not required additional therapies for 24 months, as there are no signs of recurrence. Conclusions The present case suggests that preoperative radiotherapy might be an effective treatment options for locally advanced colon cancer.
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spelling doaj-art-a52b516b12cd4d2aa32591dc3281e9402025-08-20T03:37:05ZengJapan Surgical SocietySurgical Case Reports2198-77932018-06-01411510.1186/s40792-018-0466-8Pathological complete response of locally advanced colon cancer after preoperative radiotherapy: a case report and narrative review of the literatureSho Sekiya0Kiyotaka Imamura1Shintaro Takeuchi2Koichi Teramura3Yusuke Watanabe4Eiji Tamoto5Minoru Takada6Yoshihiro Kinoshita7Yoshiyasu Anbo8Fumitaka Nakamura9Nobuichi Kashimura10Hiroko Noguchi11Katsutoshi Miura12Satoshi Hirano13Department of Gastroenterological Surgery, Teine Keijinkai HospitalDepartment of Gastroenterological Surgery, Teine Keijinkai HospitalDepartment of Gastroenterological Surgery, Teine Keijinkai HospitalDepartment of Gastroenterological Surgery, Teine Keijinkai HospitalDepartment of Gastroenterological Surgery, Teine Keijinkai HospitalDepartment of Gastroenterological Surgery, Teine Keijinkai HospitalDepartment of Gastroenterological Surgery, Teine Keijinkai HospitalDepartment of Gastroenterological Surgery, Teine Keijinkai HospitalDepartment of Gastroenterological Surgery, Teine Keijinkai HospitalDepartment of Gastroenterological Surgery, Teine Keijinkai HospitalDepartment of Gastroenterological Surgery, Teine Keijinkai HospitalDepartment of Pathology, Teine Keijinkai HospitalDepartment of Radiology, Teine Keijinkai HospitalDepartment of Gastroenterological Surgery II, Hokkaido University Faculty of MedicineAbstract Background The oncological effectiveness of preoperative radiotherapy for locally advanced colon cancer is unclear. We report a case of pathological complete response in a patient with locally advanced ascending colon cancer after preoperative radiotherapy following failure of chemotherapy. Case presentation A 65-year-old Japanese woman presented with malaise and hematochezia. A computed tomography (CT) revealed a tumor in the ascending colon which seemed to infiltrate the adjacent structures. She was diagnosed with locally advanced ascending colon cancer stages T4b, N2a, M0, and IIIC. We selected modified FOLFOX6 with panitumumab as neoadjuvant chemotherapy. However, we discontinued the chemotherapy after the 8th cycle because of disease progression and severe adverse effects. The patient then underwent radiotherapy of 60 Gy in 30 fractions, resulting in significant tumor size reduction. One month after the radiotherapy, we performed a right hemicolectomy with multivisceral resection without complications. Histopathologically, we found no residual cancer cells in the resected specimen. The patient remains alive and has not required additional therapies for 24 months, as there are no signs of recurrence. Conclusions The present case suggests that preoperative radiotherapy might be an effective treatment options for locally advanced colon cancer.http://link.springer.com/article/10.1186/s40792-018-0466-8Colon cancerRadiotherapyPathological complete response
spellingShingle Sho Sekiya
Kiyotaka Imamura
Shintaro Takeuchi
Koichi Teramura
Yusuke Watanabe
Eiji Tamoto
Minoru Takada
Yoshihiro Kinoshita
Yoshiyasu Anbo
Fumitaka Nakamura
Nobuichi Kashimura
Hiroko Noguchi
Katsutoshi Miura
Satoshi Hirano
Pathological complete response of locally advanced colon cancer after preoperative radiotherapy: a case report and narrative review of the literature
Surgical Case Reports
Colon cancer
Radiotherapy
Pathological complete response
title Pathological complete response of locally advanced colon cancer after preoperative radiotherapy: a case report and narrative review of the literature
title_full Pathological complete response of locally advanced colon cancer after preoperative radiotherapy: a case report and narrative review of the literature
title_fullStr Pathological complete response of locally advanced colon cancer after preoperative radiotherapy: a case report and narrative review of the literature
title_full_unstemmed Pathological complete response of locally advanced colon cancer after preoperative radiotherapy: a case report and narrative review of the literature
title_short Pathological complete response of locally advanced colon cancer after preoperative radiotherapy: a case report and narrative review of the literature
title_sort pathological complete response of locally advanced colon cancer after preoperative radiotherapy a case report and narrative review of the literature
topic Colon cancer
Radiotherapy
Pathological complete response
url http://link.springer.com/article/10.1186/s40792-018-0466-8
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