Case Report
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. May 15, 2024; 16(5): 2219-2224
Published online May 15, 2024. doi: 10.4251/wjgo.v16.i5.2219
Chemoradiotherapy plus tislelizumab for mismatch repair proficient rectal cancer with supraclavicular lymph node metastasis: A case report
Wen-Tao Zhong, Yuan Lv, Qian-Yu Wang, Ran An, Gang Chen, Jun-Feng Du
Wen-Tao Zhong, The Second School of Clinical Medicine, Southern Medical University, Guangzhou 510515, Guangdong Province, China
Yuan Lv, Qian-Yu Wang, Gang Chen, Jun-Feng Du, Department of General Surgery, The 7th Medical Center of PLA General Hospital, Beijing 100700, China
Ran An, Department of Pathology, The 7th Medical Center of PLA General Hospital, Beijing 100700, China
Co-first authors: Wen-Tao Zhong and Yuan Lv.
Co-corresponding authors: Gang Chen and Jun-Feng Du.
Author contributions: Zhong WT and Lv Y contributed to data collection, the conceptualization and drafted the manuscript; An R and Wang QY analyzed the data; Chen G and Du JF were involved in the writing, review and editing of the manuscript; all authors were involved in the critical review of the results and have contributed to, read, and approved the final manuscript. Zhong WT and Lv Y contributed equally to this work as co-first authors. The reasons are as following. This research was conducted as a collaborative effort. Zhong WT and Lv Y collaborated on the writing and data analysis of the article, they made equal and substantial efforts throughout the entire research process. The designation of their co-first authors accurately reflect the distribution of relevant responsibilities and burdens and ultimately improves the quality of the paper. Chen G and Du JF were designated as co-corresponding authors, because the entire research team is composed of researchers with different professional backgrounds, and the designation of co-corresponding authors best reflects this diversity. Chen G and Du JF participated in the writing, review and editing of the manuscript, through professional analysis and editing, the quality of the article has been significantly improved. In conclusion, our co-authors and co-corresponding authors designations are completely correct and confirmed by all authors.
Supported by National Natural Science Foundation of China, No. 81870393.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jun-Feng Du, MD, Adjunct Professor, Department of General Surgery, The 7th Medical Center of PLA General Hospital, No. 5 NanmenCang, Beijing 100700, China. dujunfeng@301hospital.com.cn
Received: November 14, 2023
Peer-review started: November 14, 2023
First decision: January 31, 2024
Revised: February 8, 2024
Accepted: March 14, 2024
Article in press: March 14, 2024
Published online: May 15, 2024
Processing time: 177 Days and 8.4 Hours
Abstract
BACKGROUND

According to the latest report, colorectal cancer is still one of the most prevalent cancers, with the third highest incidence and mortality worldwide. Treatment of advanced rectal cancer with distant metastases is usually unsatisfactory, especially for mismatch repair proficient (pMMR) rectal cancer, which leads to poor prognosis and recurrence.

CASE SUMMARY

We report a case of a pMMR rectal adenocarcinoma with metastases of multiple lymph nodes, including the left supraclavicular lymph node, before treatment in a 70-year-old man. He received full courses of chemoradiotherapy (CRT) followed by 4 cycles of programmed death 1 inhibitor Tislelizumab, and a pathologic complete response (pCR) was achieved, and the lesion of the left supraclavicular lymph node also disappeared.

CONCLUSION

pMMR advanced rectal cancer with preserved intact distant metastatic lymph nodes may benefit from full-course CRT combined with immunotherapy.

Keywords: Rectal cancer, Metastasis, Chemoradiotherapy, Immunotherapy, Prognosis, Case report

Core Tip: Rectal cancer is a clinically common malignancy and the mainstream treatment methods are chemoradiotherapy (CRT) and surgery. Advanced rectal cancer is often associated with distant organs and lymph node metastasis. We report a case of mismatch repair proficient rectal cancer with left supraclavicular lymph node metastasis. The patient received 4 cycles of CRT combined with immunotherapy and achieved pCR. This case provides a rare clinical experience for such patients.