Prognostic Impact of R0 Resection and Targeted Therapy for Colorectal Cancer with Synchronous Peritoneal Metastasis

Shida, Dai; Yoshida, Takefumi; Tanabe, Taro; Tsukamoto, Shunsuke; Ochiai, Hiroki; Kanemitsu, Yukihide

doi:10.1245/s10434-018-6436-3

Cited by 34 publications

(27 citation statements)

References 23 publications

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“…Some cases of long-term survival have been reported in which localized peritoneal metastasis (P1, P2) was resected alongside the primary tumor [287][288][289][290]. Simultaneous localized dissemination (P1, P2) that can be excised without excessive risk should be resected along with the primary tumor.…”

Section: Commentsmentioning

confidence: 99%

Japanese Society for Cancer of the Colon and Rectum (JSCCR) guidelines 2019 for the treatment of colorectal cancer

et al. 2019

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The number of deaths from colorectal cancer in Japan continues to increase. Colorectal cancer deaths exceeded 50,000 in 2016. In the 2019 edition, revision of all aspects of treatments was performed, with corrections and additions made based on knowledge acquired since the 2016 version (drug therapy) and the 2014 version (other treatments). The Japanese Society for Cancer of the Colon and Rectum guidelines 2019 for the treatment of colorectal cancer (JSCCR guidelines 2019) have been prepared to show standard treatment strategies for colorectal cancer, to eliminate disparities among institutions in terms of treatment, to eliminate unnecessary treatment and insufficient treatment and to deepen mutual understanding between healthcare professionals and patients by making these guidelines available to the general public. These guidelines have been prepared by consensuses reached by the JSCCR Guideline Committee, based on a careful review of the evidence retrieved by literature searches and in view of the medical health insurance system and actual clinical practice settings in Japan. Therefore, these guidelines can be used as a tool for treating colorectal cancer in actual clinical practice settings. More specifically, they can be used as a guide to obtaining informed consent from patients and choosing the method of treatment for each patient. Controversial issues were selected as clinical questions, and recommendations were made. Each recommendation is accompanied by a classification of the evidence and a classification of recommendation categories based on the consensus reached by the Guideline Committee members. Here, we present the English version of the JSCCR guidelines 2019.

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Section: Commentsmentioning

confidence: 99%

Japanese Society for Cancer of the Colon and Rectum (JSCCR) guidelines 2019 for the treatment of colorectal cancer

et al. 2019

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“…Multivariate analyses were performed using Cox proportional hazards regression models to evaluate the prognostic impact of each factor on OS. The following known factors were included: age (1), gender, ECOG performance status, location of primary tumor(21), CEA levels (18), histological type, M category (19), and surgical treatment, as well as CONUT score, PNI, and mGPS, given the overlap in elements constituting each measure.…”

Section: Discussionmentioning

confidence: 99%

“…For follow-up after curative resection, serum tumor marker measurements were performed every one to three months, and computed tomography (CT) scans were performed every three to six months, with a cut-off date of July 2019, as described previously (18,19). According to Japanese Society for Cancer of the Colon and Rectum (JSCCR) guidelines 2016 (20), postoperative chemotherapy after curative resection was not usually performed.…”

Section: Treatment and Follow-upmentioning

confidence: 99%

Nutritional and Inflammatory Measures Predict Survival of Patients with Stage IV Colorectal Cancer

Takamizawa

Shida

Boku

et al. 2020

Preprint

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Abstract Background: The present study aimed to evaluate the prognostic impact of nutritional and inflammatory measures (controlling nutritional status (CONUT) score, prognostic nutritional index (PNI) and modified Glasgow prognostic score (mGPS)) on overall survival (OS) in patients with stage IV colorectal cancer (CRC).Methods: Subjects were 996 patients with stage IV CRC who were referred to the National Cancer Center Hospital between 2001 and 2015. We retrospectively investigated correlations between OS and CONUT score, PNI, and mGPS. Multivariate analyses were performed using Cox proportional hazards regression models.Results: After adjusting for known factors (age, gender, ECOG performance status, location of primary tumor, CEA levels, histological type, M category, and prior surgical treatment), all three measures were found to be independent prognostic factors for OS in patients with stage IV CRC (CONUT score, p<0.001; PNI, p<0.001; mGPS, p<0.001). Significant differences in OS were found between low CONUT score (0/1) (n=614; 61%) and intermediate CONUT score (2/3) (n=276; 28%) (hazard ratio (HR)=1.20, p=0.031), and intermediate CONUT score and high CONUT score (≥4) (n=106; 11%) (HR=1.30, p=0.044). For mGPS, significant differences in OS were found between mGPS=0 (n=633; 64%) and mGPS=1 (n=234; 23%) (HR=1.83, p<0.001), but not between mGPS=1 and mGPS=2 (n=129; 13%) (HR=1.13, p=0.319). Patients with low PNI (<48.0) (n=443; 44%) showed a significantly lower OS rate than those with high PNI (≥48.0) (n=553; 56%) (HR=1.33, p<0.001).Conclusions: CONUT score, PNI, and mGPS were found to be independent prognostic factors for OS in patients with stage IV CRC, suggesting that nutritional and inflammatory status is a useful host-related prognostic indicator in stage IV CRC.Trial registration: retrospectively registered

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“…Despite the adoption of CRS and HIPEC in many centers worldwide, this approach is still met with criticism. One of the arguments against CRS and HIPEC is high morbidity and mortality risk of these procedures (30)(31)(32). However, whether patients with PM from CRC can attain equivalent long-term survival with systemic therapy alone is doubtful (8)(9)(10).…”

Section: Discussionmentioning

confidence: 99%

Thirty-Three Long-Term Survivors After Cytoreductive Surgery in Patients With Peritoneal Metastases From Colorectal Cancer: A Retrospective Descriptive Study

Kamada

Hida

Ishibashi

et al. 2020

Preprint

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BackgroundCytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) improves survival in selected patients with peritoneal metastasis (PM) from colorectal cancer (CRC). However, little has been reported on characteristics and clinical course of long-term survivors with CRC-PM beyond 5 years. The objective of this study was to describe the clinical and oncological features affecting long-term survival of CRC-PM after comprehensive treatment.MethodsBetween January 1990 and April 2015, CRC-PM patients who underwent CRS with or without HIPEC in two Japanese tertiary hospitals and who survived longer than 5 years after the first CRS for PM were retrospectively investigated. Clinicopathological parameters and therapeutic details involved in long-term survival were reviewed. Patients were defined as cured if the recurrence-free interval was > 5 years after the last operation for metastases.ResultsThirty-three patients with a median peritoneal cancer index (PCI) of 4 (range, 1–27) were included. Complete cytoreduction was achieved in all 33 patients, and none had a rectal primary. Recurrence was observed in 19 patients (57.6%) at a median of 2.6 (range, 0.7–7.4) years. Sixteen patients (48.5%) were considered cured, of whom two never developed re-recurrence after the second surgery. The median PCI of cured group was 2 (range, 1–8).ConclusionsLong-term survival and cure were obtained after CRS in selected patients with CRC-PM. Low PCI, complete cytoreduction, and non-rectal primary are associated with long-term survival and cure in PM from CRC.

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Prognostic Impact of R0 Resection and Targeted Therapy for Colorectal Cancer with Synchronous Peritoneal Metastasis

Abstract: If achievable, R0 resection is a desirable therapeutic strategy for patients with M1c colorectal cancer. Moreover, targeted therapy might be the optimal chemotherapy in this patient population.

Cited by 34 publications

References 23 publications

Japanese Society for Cancer of the Colon and Rectum (JSCCR) guidelines 2019 for the treatment of colorectal cancer

Japanese Society for Cancer of the Colon and Rectum (JSCCR) guidelines 2019 for the treatment of colorectal cancer

Nutritional and Inflammatory Measures Predict Survival of Patients with Stage IV Colorectal Cancer

Thirty-Three Long-Term Survivors After Cytoreductive Surgery in Patients With Peritoneal Metastases From Colorectal Cancer: A Retrospective Descriptive Study

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