[Long-Term Survival in a Case of Rectal Cancer with Peritoneal Dissemination and Multiple Organ Metastasis after Several Laparotomy].

The patient was a 64-year-old man. In January 2018, laparoscopic low anterior resection and resection of peritoneal dissemination were performed for simultaneous liver metastasis and peritoneal dissemination of rectal cancer. Histologically, the tumor was moderately differentiated adenocarcinoma/mucinous carcinoma, pT4aN2aM1c2, Stage Ⅳc. Five courses of CapeOX+bevacizumab(Bmab)were administered postoperatively, and in June 2018, hepatectomy and resection of peritoneal dissemination were performed. Chemotherapy was restarted and 3 courses were performed, but splenic metastasis was observed, so the patient was changed to CapeIRI+Bmab and 11 courses were performed, followed by splenectomy and resection of peritoneal dissemination in October 2019. Chemotherapy was discontinued after 4 courses of Capecitabine postoperatively, but gastric intramural metastasis, recurrence of peritoneal dissemination, and transverse colon cancer were discovered, and local gastric resection, resection of peritoneal dissemination, and partial transverse colectomy were performed in July 2020. After that, capecitabine+Bmab was administered for 8 courses and discontinued. Six years and 6 months have passed since the initial surgery, and the patient is still alive without recurrence.