Suh JW, Jo JW, Park DG. Long-term survival of a patient with colorectal cancer with peritoneal carcinomatosis and low completeness of cytoreduction score: A case report. World J Gastrointest Oncol 2025; 17(6): 106846 [DOI: 10.4251/wjgo.v17.i6.106846]
Corresponding Author of This Article
Dong-Guk Park, PhD, CEO, Full Professor, Department of Surgery, Dankook University Hospital, 201 Manghyang-ro, Cheonan 31116, Chungcheongnam-do, South Korea. dkp21876@gmail.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Oncol. Jun 15, 2025; 17(6): 106846 Published online Jun 15, 2025. doi: 10.4251/wjgo.v17.i6.106846
Long-term survival of a patient with colorectal cancer with peritoneal carcinomatosis and low completeness of cytoreduction score: A case report
Jung Wook Suh, Jae Won Jo, Dong-Guk Park
Jung Wook Suh, Jae Won Jo, Dong-Guk Park, Department of Surgery, Dankook University Hospital, Cheonan 31116, Chungcheongnam-do, South Korea
Author contributions: Suh JW drafted the manuscript; Jo JW curated the data; Park D reviewed and edited the manuscript.
Supported by a Research Fund from Dankook University in 2024, No. R202400759.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
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: Dong-Guk Park, PhD, CEO, Full Professor, Department of Surgery, Dankook University Hospital, 201 Manghyang-ro, Cheonan 31116, Chungcheongnam-do, South Korea. dkp21876@gmail.com
Received: March 9, 2025 Revised: March 27, 2025 Accepted: April 27, 2025 Published online: June 15, 2025 Processing time: 97 Days and 4.5 Hours
Abstract
BACKGROUND
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.
CASE SUMMARY
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.
CONCLUSION
Aggressive multimodal treatment may yield long-term survival and quality of life improvement in patients with advanced disease, even with high CCR scores.
Core Tip: Long-term survival of patients with a completeness of cytoreduction score of 3 is rarely observed; nonetheless, a favorable outcome was attained in this case by using tailored, multimodal treatment. Despite a substantial residual tumor burden, the 61-year-old female patient survived at least 6 years, suggesting the benefit of aggressive, multimodal treatment even in advanced disease. Despite the challenges in preoperatively identifying patients suited for cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy, administering the most effective therapy that the patient can tolerate is likely to produce positive outcomes.
