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Successful management of pelvic recurrence of MSI-High endometrial cancer by total pelvic exenteration followed by administration of pembrolizumab:A case report

Manabu Kojima, Shu Soeda, Chikako Okabe, Tetsu Sato, Norihito Kamo, Makiko Ueda, Yuta Endo, Shinji Nomura, Emi Tokuda, Shigenori Furukawa, Masao Kataoka, Shotaro Fujita, Shigehira Saji, Takafumi Watanabe, Keiya Fujimori

Author information

  • Manabu Kojima

    Department of Obstetrics and Gynecology, Fukushima Medical University School of Medicine

  • Shu Soeda

    Department of Obstetrics and Gynecology, Fukushima Medical University School of Medicine

  • Chikako Okabe

    Department of Obstetrics and Gynecology, Fukushima Medical University School of Medicine

  • Tetsu Sato

    Department of Obstetrics and Gynecology, Fukushima Medical University School of Medicine

  • Norihito Kamo

    Department of Obstetrics and Gynecology, Fukushima Medical University School of Medicine

  • Makiko Ueda

    Department of Obstetrics and Gynecology, Fukushima Medical University School of Medicine

  • Yuta Endo

    Department of Obstetrics and Gynecology, Fukushima Medical University School of Medicine

  • Shinji Nomura

    Department of Obstetrics and Gynecology, Fukushima Medical University School of Medicine

  • Emi Tokuda

    Department of Medical Oncology, Fukushima Medical University School of Medicine

  • Shigenori Furukawa

    Department of Obstetrics and Gynecology, Fukushima Medical University School of Medicine

  • Masao Kataoka

    Department of Urology, Fukushima Medical University School of Medicine

  • Shotaro Fujita

    Department of Gastrointestinal Tract Surgery, Fukushima Medical University School of Medicine

  • Shigehira Saji

    Department of Medical Oncology, Fukushima Medical University School of Medicine

  • Takafumi Watanabe

    Department of Obstetrics and Gynecology, Fukushima Medical University School of Medicine

  • Keiya Fujimori

    Department of Obstetrics and Gynecology, Fukushima Medical University School of Medicine

Abstract

Surgery can be curative treatment for pelvic locoregional recurrence of endometrial cancer; however, a cure is contingent on complete resection. Here, we report the case of a patient in whom recurrent endometrial tumor remained in the pelvis after resection; long-term control was achieved with postoperative administration of pembrolizumab.


The patient had recurrent endometrial cancer of stage IA and was treated with chemotherapy and radiation, but tumor persisted in the pelvic cavity. We therefore attempted total pelvic exenteration, but the tumor was adherent to the pelvic wall and complete resection could not be achieved. However, postoperative administration of pembrolizumab controlled the residual tumor for more than two years without regrowth. We believe that since the resected tumor was MSI-High, the residual tumor responded well to pembrolizumab. It is not known whether cytoreductive surgery contributes to a long-term response to pembrolizumab, but at least in our patient, pembrolizumab appeared to be a very effective drug therapy for MSI-High endometrial cancer that was refractory to chemotherapy and radiotherapy.

The cintent of reseach paper

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