Adenocarcinoma of the retroperitoneal ascending and descending colon: Sites of initial dissemination and clinical patterns of recurrence following surgery alone

Russell, Anthony H.; Tong, Daphne; Dawson, Lynne E.; Wisbeck, William M.; Griffin, Thomas W.; Laramore, George E.; Luk, Kenneth H.

doi:10.1016/0360-3016(83)90297-3

Cited by 44 publications

(13 citation statements)

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“…After apparently curative resection of the primary tumor, the liver is often the first site of metastatic disease and may be the only site of spread in as many as 30% of the patients (1,2). Hepatic resection is the only potentially curative treatment in a subset of patients with colorectal liver metastases.…”

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confidence: 99%

Improved Selection of Patients for Hepatic Surgery of Colorectal Liver Metastases with ¹⁸F-FDG PET: A Randomized Study

et al. 2009

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With the increasing possibilities for surgical treatment of colorectal liver metastases, careful selection of patients who may benefit from surgical treatment becomes critical. The addition of PET to 18 F-FDG may significantly improve conventional staging by CT. Up to now, definitive evidence that the addition of 18 F-FDG PET to conventional staging leads to superior clinical results and improved clinical management in these patients has been lacking. In this randomized controlled trial in patients with colorectal liver metastases, we investigated whether the addition of 18 F-FDG PET is beneficial and reduces the number of futile laparotomies. Methods: A total of 150 patients with colorectal liver metastases selected for surgical treatment by imaging with CT were randomly assigned to CT only (n 5 75) or CT plus 18 F-FDG PET (n 5 75). Patients were followed up for at least 3 y. The primary outcome measure was futile laparotomy, defined as any laparotomy that did not result in complete tumor treatment, that revealed benign disease, or that did not result in a disease-free survival period longer than 6 mo. Results: Patient and tumor characteristics were similar for both groups. The number of futile laparotomies was 34 (45%) in the control arm without 18 F-FDG PET and 21 (28%) in the experimental arm with 18 F-FDG PET; the relative risk reduction was 38% (95% confidence interval, 4%260%, P 5 0.042). Conclusion: The number of futile laparotomies was reduced from 45% to 28%; thus, the addition of 18 F-FDG PET to the work-up for surgical resection of colorectal liver metastases prevents unnecessary surgery in 1 of 6 patients.

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Improved Selection of Patients for Hepatic Surgery of Colorectal Liver Metastases with ¹⁸F-FDG PET: A Randomized Study

et al. 2009

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“…Recurrence at the peritoneal surface is reported in 10-20% of patients after curative colon cancer resection. In 10-35% of all patients with recurrent disease, tumor recurrence is confined to the peritoneal surface only [20,21]. Recurrent tumor cells may originate from the serosal surface of the primary tumor into the peritoneal cavity or as a result of tumor spill during surgery.…”

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confidence: 99%

Expression of human apolipoprotein(a) kringles in colon cancer cells suppresses angiogenesis‐dependent tumor growth and peritoneal dissemination

Yu¹,

Ahn²,

Lee³

et al. 2004

The Journal of Gene Medicine

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“…La survenue de métastases péritonéales (MP) est un événe-ment grave synchrone du primitif dans 10-15 % des cas et métachrone du primitif dans 20-30 % des cas [1,2]. Point important : il s'agit de l'unique localisation métastatique dans 30-40 % de ces cas [1,3].…”

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Chirurgie à visée curative des métastases péritonéales

et al. 2014

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L'exérèse complète des métastases péritonéales (MP), suivie de chimiohyperthermie intrapéritonéale (CHIP, dont l'impact thérapeutique précis n'est pas encore connu), permet d'obtenir de nombreuses guérisons chez les patients éligibles. C'est devenu le standard thérapeutique lorsqu'elle est possible. Ces résultats en termes de survie sont strictement identiques à ceux des hépatectomies pour métastases hépatiques (MH). La survie des patients présentant des MP débutantes est particulièrement bonne, bien supérieure à celle de tout patient hépatectomisé pour MH. La principale avancée sera de savoir opérer tôt les patients présentant des MP débutantes ou ceux qui ont un haut risque de développer des MP. Le concept de second-look + CHIP découle tout logiquement de ce constat. À l'opposé, une exérèse incomplète des MP contre-indique la CHIP, de même qu'une extension péritonéale importante (même si elle est complè-tement résécable). Mots clés Métastases péritonéales · Cancers colorectaux · Chimiohyperthermie intrapéritonéale · Chirurgie de réductionAbstract The complete resection of the peritoneal metastases (PM), followed with HIPEC (hyperthermic intraperitoneal chemotherapy, whose precise therapeutic impact is not yet well-known), allows to obtain numerous cures in eligible patients. This is currently the gold-standard treatment when it is possible. Its survival results are strictly similar to those obtained with hepatectomy for liver metastases (LM). The survival rate of the patients with early PM is particularly high, far superior to those of any hepatectomized patient. The main progress will be to early-operate these patients, or to propose a prophylactic approach to those presenting a high-risk to develop PM. The concept of secondlook surgery + HIPEC is the logical extension of this combined approach. In contrast, a non-complete cytoreductive surgery and a large peritoneal extension are contraindications to use this approach.

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Adenocarcinoma of the retroperitoneal ascending and descending colon: Sites of initial dissemination and clinical patterns of recurrence following surgery alone

Cited by 44 publications

References 7 publications

Improved Selection of Patients for Hepatic Surgery of Colorectal Liver Metastases with ¹⁸F-FDG PET: A Randomized Study

Improved Selection of Patients for Hepatic Surgery of Colorectal Liver Metastases with ¹⁸F-FDG PET: A Randomized Study

Expression of human apolipoprotein(a) kringles in colon cancer cells suppresses angiogenesis‐dependent tumor growth and peritoneal dissemination

Chirurgie à visée curative des métastases péritonéales

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Adenocarcinoma of the retroperitoneal ascending and descending colon: Sites of initial dissemination and clinical patterns of recurrence following surgery alone

Cited by 44 publications

References 7 publications

Improved Selection of Patients for Hepatic Surgery of Colorectal Liver Metastases with 18F-FDG PET: A Randomized Study

Improved Selection of Patients for Hepatic Surgery of Colorectal Liver Metastases with 18F-FDG PET: A Randomized Study

Expression of human apolipoprotein(a) kringles in colon cancer cells suppresses angiogenesis‐dependent tumor growth and peritoneal dissemination

Chirurgie à visée curative des métastases péritonéales

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Improved Selection of Patients for Hepatic Surgery of Colorectal Liver Metastases with ¹⁸F-FDG PET: A Randomized Study

Improved Selection of Patients for Hepatic Surgery of Colorectal Liver Metastases with ¹⁸F-FDG PET: A Randomized Study