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.