Pathologic complete response after palliative 3rd line chemotherapy with capecitabine alone in metastatic colorectal cancer

We report the case of a 46-year-old female who showed excellent clinical outcomes after palliative 3rd line capecitabine monotherapy followed by 2nd liver metastasectomy. She had been diagnosed with colon cancer with liver metastasis and initially treated with synchronous colectomy and liver metastasectomy. But she experienced immediate relapse in liver and received palliative 1st line FOLFIRI and 2nd line FOLFOX, both of which failed to show responses. Capecitabine alone as palliative 3rd line treatment did show clinical response in this patient, indeed, and she received 2nd liver metastasectomy which revealed pathologic complete response. In this report, we intended to emphasize that response to chemotherapy could be an important factor in patients who are potential candidates for metastasectomy and that catching the very moment of repeated metastasectomy is in the state of the art.