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01.04.2014 | Original Article—Alimentary Tract

Clinical benefit of surgery for stage IV colorectal cancer with synchronous peritoneal metastasis

verfasst von: Hirotoshi Kobayashi, Kenjiro Kotake, Kimihiko Funahashi, Kazuo Hase, Koichi Hirata, Tsuneo Iiai, Shingo Kameoka, Yukihide Kanemitsu, Koutarou Maeda, Akihiko Murata, Masayuki Ohue, Kazuo Shirouzu, Keiichi Takahashi, Toshiaki Watanabe, Hideaki Yano, Toshimasa Yatsuoka, Yojiro Hashiguchi, Kenichi Sugihara, Study Group for Peritoneal Metastasis from Colorectal Cancer by the Japanese Society for Cancer of the Colon and Rectum

Erschienen in: Journal of Gastroenterology | Ausgabe 4/2014

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Abstract

Background

Peritoneal metastasis is well-known as a poor prognostic factor in patients with colorectal cancer. It is important to improve the prognosis of patients with colorectal cancer and synchronous peritoneal metastasis. This study aimed to clarify the factors affecting R0 resection and the prognosis of colorectal cancer patients with synchronous peritoneal metastasis.

Methods

We investigated the data of patients with stage IV colorectal cancer between 1991 and 2007 in 16 hospitals that were members of the Japanese Society for Cancer of the Colon and Rectum.

Results

Of the 564 colorectal cancer patients with synchronous peritoneal metastases, 341 also had hematogenous metastases. The 5-year overall survival rates in patients with and without R0 resection were 32.4 and 4.7 %, respectively. A Cox proportional hazards model showed that histologic type of poorly differentiated adenocarcinoma, regional lymph node metastasis, liver metastasis, chemotherapy after surgery, R0 resection, the Japanese classification of peritoneal metastasis, and the size of peritoneal metastases were independent prognostic factors. Of the 564 patients, 28.4 % had R0 resection. The Japanese classification of peritoneal metastasis (P1–P2, p = 0.0024) and absence of hematogenous metastases (p < 0.0001) were associated with R0 resection.

Conclusions

P1–P2 peritoneal metastasis and the absence of hematogenous metastasis were the most favorable factors benefiting from synchronous resection of peritoneal metastasis. In addition, chemotherapy after surgery was essential.

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Titel: Clinical benefit of surgery for stage IV colorectal cancer with synchronous peritoneal metastasis
verfasst von: Hirotoshi Kobayashi
Kenjiro Kotake
Kimihiko Funahashi
Kazuo Hase
Koichi Hirata
Tsuneo Iiai
Shingo Kameoka
Yukihide Kanemitsu
Koutarou Maeda
Akihiko Murata
Masayuki Ohue
Kazuo Shirouzu
Keiichi Takahashi
Toshiaki Watanabe
Hideaki Yano
Toshimasa Yatsuoka
Yojiro Hashiguchi
Kenichi Sugihara
Study Group for Peritoneal Metastasis from Colorectal Cancer by the Japanese Society for Cancer of the Colon and Rectum
Publikationsdatum: 01.04.2014
Verlag: Springer Japan
Erschienen in: Journal of Gastroenterology / Ausgabe 4/2014
Print ISSN: 0944-1174
Elektronische ISSN: 1435-5922
DOI: https://doi.org/10.1007/s00535-013-0820-3

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Clinical benefit of surgery for stage IV colorectal cancer with synchronous peritoneal metastasis

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