Manuel-Vazquez A, Soria Tristán M, Luján DR, Gortázar de las Casas S, Valle Rubio A, Ramos Rodríguez JL, García-Septiem J. Rethinking treatment for non-metastatic deficient mismatch repair colorectal and small bowel cancers. World J Clin Oncol 2026; 17(9): 125491 [DOI: 10.5306/wjco.125491]
Corresponding Author of This Article
Alba Manuel-Vazquez, MD, PhD, Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid, Calle tajo s/n, Villaviciosa de Odon 28670, Madrid, Spain. alba_manuel_vazquez@hotmail.com
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Surgery
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research-article
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Manuel-Vazquez A, Soria Tristán M, Luján DR, Gortázar de las Casas S, Valle Rubio A, Ramos Rodríguez JL, García-Septiem J. Rethinking treatment for non-metastatic deficient mismatch repair colorectal and small bowel cancers. World J Clin Oncol 2026; 17(9): 125491 [DOI: 10.5306/wjco.125491]
World J Clin Oncol. Sep 24, 2026; 17(9): 125491 Published online Sep 24, 2026. doi: 10.5306/wjco.125491
Rethinking treatment for non-metastatic deficient mismatch repair colorectal and small bowel cancers
Alba Manuel-Vazquez, Miguel Soria Tristán, David Ricardo Luján, Sara Gortázar de las Casas, Ainhoa Valle Rubio, José Luis Ramos Rodríguez, Javier García-Septiem
Alba Manuel-Vazquez, Ainhoa Valle Rubio, José Luis Ramos Rodríguez, Faculty of Medicine, Health, and Sports, Universidad Europea de Madrid, Villaviciosa de Odon 28670, Madrid, Spain
Alba Manuel-Vazquez, Sara Gortázar de las Casas, Ainhoa Valle Rubio, José Luis Ramos Rodríguez, Javier García-Septiem, General and Digestive Surgery, University Hospital of Getafe, Getafe 28905, Madrid, Spain
Miguel Soria Tristán, Medical Oncology, University Hospital of Getafe, Getafe 28905, Madrid, Spain
David Ricardo Luján, Pathology, University Hospital of Getafe, Getafe 28905, Madrid, Spain
Author contributions: Manuel-Vazquez A and Soria Tristán M designed the study; Manuel-Vázquez A, Ramos Rodríguez JL, and Valle Rubio A collected the clinical data; Luján DR reviewed the pathological findings; Manuel-Vázquez A performed the data analysis, interpreted the results and drafted the manuscript; Gortázar de las Casas S and García-Septiem J critically revised the manuscript; all authors read and approved the final version of the manuscript.
AI contribution statement: AI tools (ChatGPT, OpenAI) were used as assistive technologies during manuscript preparation for language editing and improvement of writing clarity. All AI-assisted outputs were carefully reviewed, verified, and revised by the authors. The authors take full responsibility for the accuracy, originality, and scientific content of the manuscript. AI tools were not used to generate original scientific data, perform independent scientific analyses, or draw scientific conclusions.
Institutional review board statement: This retrospective study was approved by the Ethics Committee of Hospital Universitario de Getafe (Approval No. 2026/106).
Informed consent statement: The requirement for informed consent was waived by the Institutional Review Board because of the retrospective nature of the study and the use of anonymized clinical data.
Conflict-of-interest statement: All the authors declare that they have no conflicts of interest related to this study.
Data sharing statement: The datasets generated and analyzed during the current study are not publicly available due to patient privacy and institutional restrictions but are available from the corresponding author on reasonable request.
Corresponding author: Alba Manuel-Vazquez, MD, PhD, Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid, Calle tajo s/n, Villaviciosa de Odon 28670, Madrid, Spain. alba_manuel_vazquez@hotmail.com
Received: July 8, 2026 Revised: July 31, 2026 Accepted: September 11, 2026 Published online: September 24, 2026 Processing time: 77 Days and 16.6 Hours
Core Tip
Core Tip: This real-world retrospective study describes eight patients with non-metastatic mismatch repair (MMR)-deficient colorectal and small bowel adenocarcinoma treated with immunotherapy in different clinical settings. Favorable responses were observed across all tumor subsites. Complete clinical responses enabled a watch-and-wait strategy in some patients with locally advanced rectal cancer. In colon cancer immunotherapy facilitated minimally invasive surgery with pathological complete responses in all operated patients. Delayed MMR testing postponed treatment initiation in some cases, highlighting the need for systematic upfront immunohistochemical assessment at diagnosis. These findings support the feasibility of implementing immunotherapy-based strategies in routine surgical oncology practice beyond clinical trial settings.
