Durable Complete Response of Colorectal Cancer Metastasis after Biochemotherapy

Area of Science:

• Oncology
• Medical Imaging
• Surgical Oncology

Background:

• Metastatic colorectal cancer (mCRC) management often involves systemic therapy followed by surgery.
• Complete response (CR) to induction therapy is uncommon, with residual disease frequently present.
• Metastasectomy indications are debated when lesions disappear or persist after systemic treatment.

Observation:

• A patient with mCRC and liver metastases received induction biochemotherapy (FOLFOX and bevacizumab).
• One liver lesion disappeared during treatment, precluding its surgical resection.
• The patient underwent incomplete metastasectomy and adjuvant chemotherapy, with no recurrence after 5 years.

Findings:

• Systemic therapy alone can achieve a durable complete response in select mCRC patients.
• Complete radiological disappearance of metastases may indicate successful treatment without the need for resection.

Implications:

• This case challenges the necessity of metastasectomy in all mCRC patients achieving CR.
• It suggests that systemic therapy alone may offer a curative option for some mCRC patients.
• Long-term surveillance is crucial for patients treated with systemic therapy alone or with incomplete resection.