Suh Jung Wook, Jo Jae Won, Park Dong-Guk
Department of Surgery, Dankook University Hospital, Cheonan 31116, Chungcheongnam-do, South Korea.
World J Gastrointest Oncol. 2025 Jun 15;17(6):106846. doi: 10.4251/wjgo.v17.i6.106846.
Peritoneal metastasis occurs in about 20% of patients with colorectal cancer (CRC) and is associated with a 5-year survival rate of only 6%. Cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy reportedly improves survival in selected patients. Achieving complete cytoreduction, indicated by a low completeness of cytoreduction (CCR) score, is a key factor in extending survival. Here, we present a case in which multimodal therapy yielded long-term survival in a patient, even though she had a CCR score of 3.
A 61-year-old female with CRC and extensive peritoneal metastases presented with abdominal distention. Cytoreductive surgery was not completed due to the extent of the disease (CCR score: 3). The patient underwent palliative omentectomy, followed by hyperthermic intraperitoneal chemotherapy with mitomycin C, and early postoperative intraperitoneal chemotherapy. She subsequently received systemic chemotherapy, which was terminated after 19 cycles and two dose reductions due to side effects. She was in good health without distant metastases or peritoneal recurrence at the 6-year follow-up.
Aggressive multimodal treatment may yield long-term survival and quality of life improvement in patients with advanced disease, even with high CCR scores.
腹膜转移发生在约20%的结直肠癌(CRC)患者中,且5年生存率仅为6%。据报道,细胞减灭术加腹腔热灌注化疗可提高部分患者的生存率。实现完全细胞减灭,以低细胞减灭完整性(CCR)评分表示,是延长生存期的关键因素。在此,我们报告一例患者,尽管其CCR评分为3,但多模式治疗仍使其获得了长期生存。
一名61岁患有CRC并伴有广泛腹膜转移的女性患者出现腹胀。由于疾病范围(CCR评分:3),细胞减灭术未完成。患者接受了姑息性大网膜切除术,随后进行了丝裂霉素C腹腔热灌注化疗及术后早期腹腔化疗。她随后接受了全身化疗,因副作用在19个周期及两次剂量减少后终止。在6年随访时,她身体健康,无远处转移或腹膜复发。
积极的多模式治疗可能使晚期疾病患者获得长期生存并改善生活质量,即使CCR评分较高。