A population‐based study on the prognostic impact of primary tumor sidedness in patients with peritoneal metastases from colon cancer

Boer, Nadine L. de; Rovers, Koen P.; Burger, Jacobus W. A.; Madsen, Eva; Brandt-Kerkhof, Alexandra R M; Kok, Niels F. M.; Wilt, Johannes H. W. de; Reuver, Philip H. de; Bos, Amanda C.R.K.; Hingh, Ignace H. J. T. de; Verhoef, Cornelis

doi:10.1002/cam4.3243

Cited by 9 publications

(5 citation statements)

References 41 publications

(99 reference statements)

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“…Consistent with previous studies, we also found that patients with right-sided colon cancer have a higher risk of developing m-PM (29,30). Compared with left-sided tumors, right-sided tumors tend to be asymptomatic until advanced.…”

Section: Discussionsupporting

confidence: 92%

WITHDRAWN: Development and validation of a nomogram for predicting metachronous peritoneal metastasis in colorectal cancer: a retrospective study

Ban

Shang

Shi

2022

Preprint

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Background: The present study aimed to establish and validate a nomogram model to predict the occurrence of metachronous peritoneal metastasis (m-PM) in colorectal cancer (CRC) within 3 years after surgery. Method: The clinical datum of 965 patients were enrolled in this study from Second Hospital of Jilin University, between January 1, 2014 and January 31, 2019. The patients were randomly divided into training and validation cohorts at a ratio of 2:1. The least absolute shrinkage and selection operator (LASSO) regression was performed to identify the variables with nonzero coefficients to predict the risk of m-PM. Multivariate logistic regression was used to verify the selected variables and to develop the predictive nomogram model. Harrell's concordance index (C-index), receiver operating characteristic (ROC) curve, Brier score, and decision curve analysis (DCA) were used to evaluate discrimination, distinctiveness, validity, and clinical utility of this nomogram model. The model was verified internally using bootstrapping method and verified externally using validation cohort.Results: The nomogram included 7 predictors: emergency operation, tumor site, histological type, pathological T stage, CA125, BRAF mutation and MSI status. The model achieved a good prediction accuracy on both the training and validation datasets. The C-index, area under the curve (AUC), and Brier scores were 0.814, 0.814 (95%CI 0.764–0.864), and 0.079, respectively, for the training cohort were 0.812, 0.812 (95%CI 0.732–0.893) and 0.087, respectively. DCA showed that when the threshold probability was between 0.01 and 0.75, using this model to predict m-PM could achieve a net clinical benefit.Conclusion: we have established and validated a nomogram model to predict m-PM in patients undergoing curative surgery, which shows good discrimination and high accuracy.Trial registration: The study was approved by Ethics Committee of the Second Hospital of Jilin University (Approval No.2021003) on January 19th.

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Section: Discussionsupporting

confidence: 92%

WITHDRAWN: Development and validation of a nomogram for predicting metachronous peritoneal metastasis in colorectal cancer: a retrospective study

Ban

Shang

Shi

2022

Preprint

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“…The overall analysis including all 7,930 CRC patients with peritoneal metastases showed that RCC was an independent prognostic factor in multivariate analysis and was significantly associated with worse OS compared to LCC (HR 1.11, 95% CI 1.03-1.19, P = (P6) 0.007). However, in the subgroup analysis limited to 564 patients who underwent CRS plus HIPEC, OS of RCC patients did not significantly differ from that of LCC patients (45). Another retrospective study from France in 2019 with 796 patients with peritoneal metastases from CRC who were treated with CRS plus HIPEC also reported the same tendency that there was no significant difference in OS or PFS between RCC and LCC (median OS 3.5 versus 4.0 years, HR = 0.99, 95% CI 3.5-4.4 years, P = 0.90) patients (46).…”

Section: Ptl and Surgical Outcome In Peritoneal Metastases From Crcmentioning

confidence: 74%

The primary tumor location in colorectal cancer: A focused review on its impact on surgical management

Nagai

Kiyomatsu

Gohda

et al. 2021

GHM

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The primary tumor location (PTL) has attracted increasing attention in recent years for colorectal cancer (CRC) patients. Although the underlying mechanisms for differences caused by PTL remain still unclear, right-sided colon (RCC) and left-sided colon (LCC) are now considered as distinct entities because of their different molecular profile and clinical response to surgery and chemotherapy. In this article, we review the influence of PTL particularly on surgical management of primary and metastatic CRC settings. For nonmetastatic CRC, RCC could be a slightly superior prognostic factor after curative resection in stage I-II CRC, while RCC could be an inferior prognostic factor in stage III CRC with worse survival after recurrence, suggesting the oncological aggressiveness of recurrent RCC. For metastatic CRC, RCC could be a predictor of worse survival after hepatectomy of liver metastases from CRC with aggressive recurrence pattern and lower chance of re-resection. In lung metastases from CRC, the role of PTL still remains uncertain because of the limited number of studies. As to the impact of PTL on survival outcome after cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy for peritoneal metastases from CRC, a discrepancy exists among studies and further investigation will be needed. The very simple clinical factor of PTL could provide important information for the prediction of the survival outcome after surgery in CRC. Further clinical and basic research will facilitate the clinical application of PTL in a more specified and personalized manner.

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“…In this cohort of patients scanned with MRI soon after diagnosis of PM, patients with a right-sided colon cancer were less likely to undergo CRS-HIPEC following the diagnosis of PM. Similarly, in a population-based cohort study of 7,930 patients with synchronous PM, patients with rightsided colon cancer were less often suitable candidates for CRS-HIPEC [30]. Patients with synchronous metastatic right-sided colorectal cancer more often had PM with or without other metastatic sites (M1c) [31].…”

Section: Discussionmentioning

confidence: 99%

“…Left-sided colon cancers more frequently metastasize to lung and liver [32,33]. Patients with left-sided tumors and PM have a higher chance to be amenable for CRS-HIPEC [15], which probably reflects less aggressive tumor behavior.…”

Section: Discussionmentioning

confidence: 99%

“…Generally, right-sided colon tumors are associated with a worse prognosis [8,9]. This is also true for patients with PM, specifically [10][11][12][13][14][15]. The twocolon concept of colon cancer is a well-established theory supported by different embryological origins, intraluminal physiology, and different mechanisms of tumorigenesis [16,17].…”

Section: Introductionmentioning

confidence: 99%

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Differences in the distribution of peritoneal metastases in right- versus left-sided colon cancer on MRI

et al. 2021

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Purpose Right-sided colon tumors with peritoneal metastases (PM) are associated with a poorer prognosis than left-sided tumors. We hypothesized that a different pattern of spread could be characterized with abdominopelvic MRI. The objective of this study was to explore the spread of PM in relation to the primary tumor location on MRI. Methods This is a retrospective cohort study of patients with PM from colon cancer referred to be considered for CRS-HIPEC at a single tertiary referral center. Patients with colon cancer were eligible if they had undergone an abdominopelvic MRI scan following a clinical diagnosis of PM. The frequency of affected PCI regions on MRI (MRI-PCI) was assessed and compared between tumor sidedness. Results One hundred eighteen patients were included with a median age of 65 (IQR: 56-72). 46% percent were male. The median MRI-PCI was 10 (IQR: 5-16) and 8 (IQR: 4-11) for right-and left-sided tumors, respectively (p = 0.39), and the median number of affected regions was 4 (IQR: 2-7 for right-sided and IQR 2-5 for left-sided tumors). PM was most frequently found close to the primary tumor. The odds ratio of patients with PM of left sided to be affected with PM in the upper abdominal regions was 0.42 (95% CI: 0.20-0.90) and with PM on the small bowels or mesentery was 0.42 (95% CI: 0.19-0.92) over a patient with PM of right-sided colon cancer. Conclusion MRI can help to assess the spread of PM in colonic cancer. In right-sided tumors, the small bowel and upper abdominal regions are more frequently affected.

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A population‐based study on the prognostic impact of primary tumor sidedness in patients with peritoneal metastases from colon cancer

Abstract: This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Cited by 9 publications

References 41 publications

WITHDRAWN: Development and validation of a nomogram for predicting metachronous peritoneal metastasis in colorectal cancer: a retrospective study

WITHDRAWN: Development and validation of a nomogram for predicting metachronous peritoneal metastasis in colorectal cancer: a retrospective study

The primary tumor location in colorectal cancer: A focused review on its impact on surgical management

Differences in the distribution of peritoneal metastases in right- versus left-sided colon cancer on MRI

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