Survival and Prognostic Factors for Metachronous Peritoneal Metastasis in Patients with Colon Cancer

Nagata, Hiroshi; Ishihara, Soichiro; Hata, Keisuke; Murono, Koji; Kaneko, Manabu; Yasuda, Koji; Otani, Kensuke; Nishikawa, Takeshi; Tanaka, Toshiaki; Kiyomatsu, Tomomichi; Kawai, Kazushige; Nozawa, Hiroaki; Watanabe, Toshiaki

doi:10.1245/s10434-016-5732-z

Cited by 50 publications

(48 citation statements)

References 45 publications

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“…This study is especially specific in that no patients underwent curative surgery, thus eliminating the heterogeneity of perioperative factors. 10 Our study found BL to be an independent predictor of DFS (3and 5-year) and OS (5-year). BL has been reported widely to be significantly associated with poorer post-operative outcomes after CRS-HIPEC.…”

Section: Discussionsupporting

confidence: 48%

“…PCI has been one of the most consistent independent predictors of morbidity and mortality from CRS-HIPEC. 2,[5][6][7][8][9] There has, however, been no consensus on a PCI cut off in CPM that predicts poorer post-operative outcomes, with studies thus far reporting a wide range (6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20) that are significantly predictive of DFS and OS. 6,8,[10][11][12] Results from our study suggest that for patients with PC from colorectal primaries, a lower cut-off value of 7-11 is a satisfactorily significant predictor of postoperative OS.…”

Section: Discussionmentioning

confidence: 99%

“…The majority of previous studies on this topic have reported on the predictive value of DFI between repeated CRS-HIPEC for higher PCI, CC score and poorer long-term survival. 9,10,13,14 Our study is one of the few to define DFI as the interval between index curative surgery and first metachronous peritoneal recurrence for which the patient underwent CRS-HIPEC. A longer DFI is a surrogate marker of favourable tumour biology, and allows optimization of nutritional and functional status preoperatively, a factor reported to be significantly associated with post-CRS-HIPEC OS.…”

Section: Discussionmentioning

confidence: 99%

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Novel prognostic score for outcomes after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for colorectal cancer with metachronous peritoneal carcinomatosis

Chin

Tan

Chia

et al. 2020

ANZ Journal of Surgery

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Background: This study aimed to determine pre-and peri-operative parameters with significant predictive value for post-operative outcomes in patients with recurrent colorectal cancer presenting as peritoneal carcinomatosis undergoing cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS-HIPEC), and to develop a novel prognostic scoring system for prediction of survival outcomes. Methods: A single-institution review of prospectively collected data from all patients who underwent CRS-HIPEC between October 2005 and October 2017 was conducted. Univariate and multivariate analyses were used to identify significant parameters for prediction of post-CRS-HIPEC disease-free survival and overall survival (OS). Results: A total of 278 patients underwent CRS-HIPEC, of whom 72 were for peritoneal carcinomatosis from recurrent colorectal cancer. Disease-free interval (DFI; P = 0.006), peritoneal cancer index (PCI; P = 0.001) and left upper quadrant disease (P = 0.023) were significant independent predictors of 3-year OS. DFI (0.007), PCI (P < 0.001) and intraoperative blood loss (BL; P = 0.001) were significant independent predictors of 5-year OS. PCI and BL were significant independent predictors of both 3-year (P = 0.026, PCI; P = 0.009, BL) and 5-year (P = 0.002, PCI; P = 0.011, BL) disease-free survival. Predictive models were developed for risk stratification of OS. Conclusion: PCI, DFI, left upper quadrant disease and BL have significant predictive value for post-CRS-HIPEC outcomes. Risk stratification models allow for more prudent patient selection and ultimately more accurate prognostication of post-operative outcomes.

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Section: Discussionsupporting

confidence: 48%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Novel prognostic score for outcomes after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for colorectal cancer with metachronous peritoneal carcinomatosis

Chin

Tan

Chia

et al. 2020

ANZ Journal of Surgery

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“…A recent study reported that 14.1 % of pathologic T4 colon cancer developed metachronous peritoneal metastasis (11) ; therefore, in the present case, metachronous peritoneal metastasis is not unnatural in itself. As it is, solitary distant peritoneal metastasis of colon cancer cephalad beyond the greater omentum similar to the present case has not been reported previously.…”

Section: The Journal Of Medical Investigation Vol 64 August 2017supporting

confidence: 46%

Solitary distant peritoneal metastasis of cecal cancer after laparoscopic colectomy: a case report

et al. 2017

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INTRODUCTIONLaparoscopic colorectal resection, which is less invasive than open colorectal resection, has been increasingly used for colorectal cancer over the last two decades. Several large randomized controlled trials have reported the superiority in terms of shortterm outcomes, including earlier recovery of bowel function and shorter hospital stay to open colorectal resection (1 -4). These trials have also reported the equivalence in terms of long -term outcomes, including disease -free survival and overall survival to open colorectal resection (5 -7) ; however, several recurrence patterns peculiar to laparoscopic colorectal resection, such as port site recurrence and peritoneal seeding, are an issue in these days (8). Both port site recurrence and peritoneal seeding are related to careless surgical procedures. We have to pay close attention to our procedures during laparoscopic surgery.We report a case of solitary distant peritoneal metastasis of cecal cancer after laparoscopic colectomy. This peritoneal metastasis seemed to be caused by surgical procedures. The present case report highlights the importance of paying close attention to surgical procedure in laparoscopic surgery to prevent peritoneal seeding. CASE PRESENTATIONA 77 -year -old Japanese female underwent laparoscopic ileocecal resection and lymph node dissection for cecal cancer by a previous doctor. Pathological examination revealed moderately differentiated tubular adenocarcinoma with positive lymph and blood vessel invasion and serosal invasion. Lymph node metastases were seen in two of the seven dissected lymph nodes. Her pathologic stage was T4aN1bM0 stage IIIB according to the TNM Classification of Malignant Tumors 7th Edition. She had undergone adjuvant chemotherapy with oral capecitabine for 6 months. Two years and 9 months after the previous operation, contrast-enhanced computed tomography (CECT) during a routine examination revealed an intraperitoneal tumor at the right subphrenic fossa ; therefore, she presented to our hospital for the treatment of the tumor.There were no remarkable findings during the physical examination. Blood biochemistry showed elevation of carcinoembryonic antigen (6.2 ng/mL) and carbohydrate antigen 19 -9 (104.4 U/mL) levels. CECT showed an intraperitoneal tumor with poor contrast enhancement at the right subphrenic tumor. We performed magnetic resonance imaging with gadolinium ethoxybenzyl-L-diethylenetriamine pentaacetic acid (EOB -MRI) in addition, and EOB -MRI also showed the right subphrenic tumor, which seemed to be located on the right diaphragm and not invasive into the liver. (Figure 1). We also performed 18F-fluorodeoxyglucose position emission tomography (FDG-PET) for a qualitative diagnosis, and FDG-PET showed fluorodeoxyglucose accumulation in the right subphrenic tumor (Figure 2). There was no evidence of further peritoneal metastasis or another distant metastasis on a previous series of examinations ; therefore, we considered the tumor to be suspicious of solitary distant peritoneal metastasis of...

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“…Median follow-up time of these patients was 63.6 months. We focused on patients with pT4 disease, a well-known risk factor of peritoneal recurrence, 2,3,6 to ensure that a sufficient number of events were evaluated to determine the clinical impacts of cancer stem cell markers on patient prognosis.…”

Section: Patients and Tissue Specimensmentioning

confidence: 99%

LGR5 expression predicts peritoneal recurrence after curative resection of primary colon cancer

et al. 2019

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BACKGROUND: The aim of this study was to clarify whether a cancer stem cell marker could be an indicator of post-operative peritoneal recurrence of colon cancer. METHODS: Expression of four putative markers (CD133, CD44 variant 6, aldehyde dehydrogenase-1 and leucine-rich repeating G-protein-coupled receptor-5 (LGR5)) was evaluated immunohistochemically in primary tumour samples from 292 patients who underwent curative resection for non-metastasised pT4 colon cancer at the University of Tokyo Hospital between 1997 and 2015. RESULTS: Peritoneal recurrence was significantly higher in LGR5-negative cases (5-year cumulative incidence: 27.5% vs. 14.4%, p = 0.037). Multivariable analysis confirmed that negative LGR5 expression was an independent risk factor for peritoneal recurrence (hazard ratio (HR) 2.79, p = 0.005) in addition to poor differentiation, positive lymph node metastasis, preoperative carcinoembryonic antigen > 5 ng/mL and anastomotic leakage. The addition of LGR5 significantly improved the predictive value of the multivariable model (net reclassification improvement: 0.186, p = 0.028: integrated discrimination improvement: 0.047, p = 0.008). CONCLUSIONS: Negative LGR5 expression was a significant predictor of peritoneal recurrence in patients with pT4 colon cancer. Therefore, LGR5 might be a promising biomarker to identify patients at high risk of post-operative peritoneal metastasis.

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Survival and Prognostic Factors for Metachronous Peritoneal Metastasis in Patients with Colon Cancer

Cited by 50 publications

References 45 publications

Novel prognostic score for outcomes after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for colorectal cancer with metachronous peritoneal carcinomatosis

Novel prognostic score for outcomes after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for colorectal cancer with metachronous peritoneal carcinomatosis

Solitary distant peritoneal metastasis of cecal cancer after laparoscopic colectomy: a case report

LGR5 expression predicts peritoneal recurrence after curative resection of primary colon cancer

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