Increase in the incidence of synchronous and metachronous peritoneal metastases in patients with colorectal cancer: A nationwide study

Lurvink, Robin J.; Bakkers, Checca; Rijken, Anouk; Erning, Felice N. van; Nienhuijs, Simon W.; Burger, Jacobus W. A.; Creemers, Geert-Jan; Verhoef, C.; Lemmens, Valery; Hingh, Ignace H. J. T. de

doi:10.1016/j.ejso.2020.11.135

Cited by 46 publications

(46 citation statements)

References 17 publications

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“…1 Approximately one third of patients are confronted with metastatic disease, either at the time of diagnosis or later during follow-up evaluation after curative treatment. 2 After the liver, the peritoneum is the second most common metastatic site of CRC. 3 , 4 Colorectal peritoneal metastases (CPM), occurring in about 10 % of CRC patients, are diagnosed during the initial treatment of the primary tumor (synchronous peritoneal metastases) or during follow-up evaluation (metachronous peritoneal metastases).…”

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confidence: 99%

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Treatment Strategies and Prognosis of Patients With Synchronous or Metachronous Colorectal Peritoneal Metastases: A Population-Based Study

et al. 2021

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Background This study aimed to compare treatment strategies and survival of patients with synchronous colorectal peritoneal metastases (CPM) and patients with metachronous CPM in a nationwide cohort. Methods All patients from the Netherlands Cancer Registry with synchronous or metachronous CPM whose primary colorectal cancer (CRC) was diagnosed between 1 January and 30 June 2015 were included in the study. Treatments were categorized as (A) cytoreductive surgery and hyperthermic intraperitoneal chemotherapy [CRS-HIPEC]; (B) palliative treatment; or (C) best supportive care. Overall survival (OS) for all the patients and disease-free survival (DFS) for those who underwent CRS-HIPEC were compared between the two groups. Results Of 7233 patients, 743 had a diagnosis of CPM, including 409 patients with synchronous CPM and 334 patients with metachronous CPM. The median OS was 8.1 months for the patients with synchronous CPM versus 12 months for the patients with metachronous CPM (p = 0.003). After multivariable correction, OS no longer differed between the patients with synchronous CPM and those with metachronous CPM (HR 1.03 [0.83–1.27]). The patients with metachronous CPM more often underwent CRS-HIPEC than the patients with synchronous CPM (16 % vs 8 %; p = 0.001). The two groups did not differ statistically in terms of DFS and OS (median DFS, 21.5 vs 14.1 months, respectively; p = 0.094; median OS, 37.8 vs. 35.8 months, respectively; p = 0.553). Conclusion This population-based study showed that survival for the patients with synchronous CPM and patients with metachronous CPM did not significantly differ. This suggests that a similar prognosis may be expected for patients selected for treatment regardless of the onset of CPM.

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“… 3 , 4 Colorectal peritoneal metastases (CPM), occurring in about 10 % of CRC patients, are diagnosed during the initial treatment of the primary tumor (synchronous peritoneal metastases) or during follow-up evaluation (metachronous peritoneal metastases). 2 …”

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Treatment Strategies and Prognosis of Patients With Synchronous or Metachronous Colorectal Peritoneal Metastases: A Population-Based Study

et al. 2021

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“…We found that synchronous CPM was associated positively with female, PROK1/PROKR2-positive, rightsided colon cancer location, poorly differentiated grade, BRAF mutations, mucinous adenocarcinoma, signet-ring cell carcinoma, N1-2, T4 and elevated serum CA19-9 (ascendingly sequenced by the value of odds ratios). Our study has provided an extensive analysis of the association between synchronous CPM and clinicopathological-molecular features, especially the molecular characteristics compared with the previously published studies [44][45][46][47]. In addition, several studies have different conclusions about the association between MSI-H and synchronous CPM, although MSI-H is a poor prognostic factor in metastatic colorectal cancer [48,49].…”

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confidence: 97%

Risk factors of synchronous peritoneal metastases in colorectal cancer: a meta-analysis

Zhang¹,

Qin²,

Wang³

et al. 2021

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Background: Early detection of synchronous colorectal peritoneal metastasis (CPM) is difficult due to the absence of typical symptoms and the low accuracy of imaging examinations. Better knowledge of risk factors for synchronous CPM may be essential for early diagnosis and strengthening management. This study aimed to clarify the risk factors. Methods: This meta-analysis was based on PRISMA guidelines. A systematic search of PubMed, Embase and Cochrane Library databases was performed. The pooled data was assessed by a random-effects model. Results: 25 studies containing 171932 patients were included. Synchronous CPM was associated positively with female (OR 1.299; 1.118 to 1.509; P = 0.001), T4 (OR 12.331; 7.734 to 19.660; P < 0.001), N1-2 (OR 5.665; 3.628 to 8.848; P < 0.001), poorly differentiated grade (OR 2.560; 1.537 to 4.265; P < 0.001), right-sided colon cancer (OR 2.468; 2.050 to 2.970; P < 0.001), mucinous adenocarcinoma (OR 3.565; 2.095 to 6.064; P < 0.001), signet-ring cell carcinoma (OR 4.480; 1.836 to 10.933; P = 0.001), elevated serum CA19-9 (OR 12.868; 5.196 to 31.867; P < 0.001), PROK1/PROKR2-positive (OR 2.244; 1.031 to 4.884; P = 0.042) and BRAF mutations (OR 2.586; 1.674 to 3.994; P < 0.001). However, it’s associated negatively with rectal cancer and non-mucinous adenocarcinoma, and not associated with KRAS, NRAS, PIK3CA mutations and MSI-H/dMMR. Conclusions: These risk factors are the alerts that could predict the presence of synchronous CPM and contribute to strengthening management and optimal therapeutic strategy.

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“…Other risk factors, such as a T4 stage and signet ring cell differentiation, were previously identified to be associated with an increased incidence of peritoneal metastases from colorectal cancer [ 36 ]. Furthermore, linitis plastica, tumour-positive lymph nodes and a primary tumour not located in the cardia were previously reported as risk factors for metastases in gastric cancer patients [ 37 ].…”

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confidence: 99%

The Burden of Peritoneal Metastases from Gastric Cancer: A Systematic Review on the Incidence, Risk Factors and Survival

Rijken

Lurvink

Luyer

et al. 2021

JCM

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The peritoneum is a common metastatic site in gastric cancer. This systematic review provides an overview of the incidence, risk factors and survival of synchronous peritoneal metastases from gastric cancer. A systematic search was performed to identify studies wherein the incidence, risk factors and survival of gastric cancer with peritoneal metastases were investigated. Of all 38 potentially eligible studies, 17 studies were included based on the eligibility criteria. The incidence of synchronous gastric peritoneal metastases was reviewed for population-based studies (10–21%), for observational cohort studies (2–15%) and for surgical cohort studies (13–40%). Potential risk factors for synchronous gastric peritoneal metastases were younger age, non-cardia gastric cancer, female sex, signet ring cell carcinoma, diffuse type histology or linitis plastica, T4 stage, Hispanic ethnicity and more than one metastatic location. Synchronous peritoneal metastases are commonly diagnosed in patients with gastric cancer with an incidence up to 21% in recent population-based studies. Furthermore, prognosis of patients with gastric peritoneal metastases is poor with median overall survival ranging from 2 to 9 months. The high incidence and poor prognosis require intensive research on diagnostic features and effective treatment options to improve survival.

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Increase in the incidence of synchronous and metachronous peritoneal metastases in patients with colorectal cancer: A nationwide study

Cited by 46 publications

References 17 publications

Treatment Strategies and Prognosis of Patients With Synchronous or Metachronous Colorectal Peritoneal Metastases: A Population-Based Study

Treatment Strategies and Prognosis of Patients With Synchronous or Metachronous Colorectal Peritoneal Metastases: A Population-Based Study

Risk factors of synchronous peritoneal metastases in colorectal cancer: a meta-analysis

The Burden of Peritoneal Metastases from Gastric Cancer: A Systematic Review on the Incidence, Risk Factors and Survival

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