Peritoneal recurrence of colorectal cancer with microsatellite instability: Is immunotherapy alone more effective than surgery?

A 67-year-old man was treated with systemic chemotherapy and cytoreductive surgery for microsatellite instable (MSI), deficient mismatch repair (dMMR) right colonic cancer with peritoneal metastases. Disease was controlled only when anti-PD1 and anti-CTLA4 immune checkpoint inhibitors were introduced. The patient is in complete remission after five years of follow-up. First-line immunotherapy could have a central role in the management of patients with peritoneal recurrence from MSI/dMMR colorectal cancer even though amenable to surgical treatment.

Evolution of the elastic fiber network of the human uterine cervix before, during and after pregnancy. A quantitative evaluation by automated image analysis.

To assess the evolution of the elastic fiber network of the human uterine cervix before, during and after pregnancy, biopsy samples were obtained from 49 women. The high affinity of the polyphenolic compound (+)-catechin for elastin was used to stain the elastic fibers selectively, and enabled automated image analysis. In the human uterine cervix, the elastic fiber network is made up of: (1) fibers running parallel to the basement lamina of the epithelium, and (2) thinner, perpendicular fibers. Quantification using automated image analysis shows a decline in the cervical elastin content from a prepregnancy level of 1.33 +/- 0.08 (SEM) to 0.73 +/- 0.09% (Vv) at the end of pregnancy. In parallel with a constant decline, dissociation and disorganization of the fibers become more clearly evident as pregnancy progresses. However, by 5-7 weeks postpartum the elastic fiber network appears almost completely restructured. These changes support a role of elastin in the processes of cervical maturation and reconstruction during pregnancy and after delivery.