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Rate of Peritoneal Carcinomatosis in Resected Stage II and III Colon Cancer

  • Peritoneal Surface Malignancy
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Introduction

Incidence of peritoneal carcinomatosis (PC) after curative resection of stage II and III colon cancer varies widely. Although certain features are considered high risk for PC, the impact of these features on PC incidence is unclear.

Methods

A retrospective analysis was performed on patients ≥ 18 years old with resected stage II and III colonic adenocarcinoma treated at two academic institutions from 2007 to 2018. Clinicopathologic features, treatment and outcomes data were recorded. Patients with reported high-risk features (pT3N0-2 with mucinous/signet ring components, pT4, pN1c, perforation) were identified. The remaining stage II and III patients were used for comparison.

Results

Of 219 eligible patients, 93/219 (42.5%) were stage II and 126/219 (57.5%) were stage III. Median follow-up time was 25 (1–146) months. Adjuvant systemic treatment was administered to 133/219 (60.7%) patients. Overall incidence of PC was 14/219 (6.4%) and the median time to PC was 18 (1–37) months. The high-risk and comparison groups contained 113 and 106 patients, respectively. Incidence of PC was significantly different between groups (high-risk 9.7% vs comparison 2.8%, p = 0.04). Median time to PC was not significantly different between the groups [high-risk 17 (1–37) months vs comparison 20 (7–36) months, p = 0.88].

Conclusion

Overall PC incidence in patients with resected stage II and III colon cancer was 6.4%. Although the high-risk group developed PC at a significantly higher rate, the rate of PC in this group was still below 10%. The results of this study represent real-world rates of PC and should be taken into account when designing future studies.

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References

  1. Franko J, Shi Q, Meyers JP, et al. Prognosis of patients with peritoneal metastatic colorectal cancer given systemic therapy: an analysis of individual patient data from prospective randomised trials from the Analysis and Research in Cancers of the Digestive System (ARCAD) database. Lancet Oncol. 2016;17(12):1709–19.

    Article  Google Scholar 

  2. Baratti D, Kusamura S, Pietrantonio F, Guaglio M, Niger M, Deraco M. Progress in treatments for colorectal cancer peritoneal metastases during the years 2010–2015. A systematic review. Crit Rev Oncol Hematol. 2016;100:209–22.

    Article  Google Scholar 

  3. Glehen O, Kwiatkowski F, Sugarbaker PH, et al. Cytoreductive surgery combined with perioperative intraperitoneal chemotherapy for the management of peritoneal carcinomatosis from colorectal cancer: a multi-institutional study. J Clin Oncol. 2004;22(16):3284–92.

    Article  CAS  Google Scholar 

  4. Quenet F, Elias D, Roca L, et al. A UNICANCER phase III trial of hyperthermic intra-peritoneal chemotherapy (HIPEC) for colorectal peritoneal carcinomatosis (PC): PRODIGE 7. J Clin Oncol. 2018;36(18):LBA3503.

    Article  Google Scholar 

  5. Verwaal VJ, Bruin S, Boot H, van Slooten G, van Tinteren H. 8-year follow-up of randomized trial: cytoreduction and hyperthermic intraperitoneal chemotherapy versus systemic chemotherapy in patients with peritoneal carcinomatosis of colorectal cancer. Ann Surg Oncol. 2008;15(9):2426–32.

    Article  Google Scholar 

  6. Verwaal VJ, van Ruth S, de Bree E, et al. Randomized trial of cytoreduction and hyperthermic intraperitoneal chemotherapy versus systemic chemotherapy and palliative surgery in patients with peritoneal carcinomatosis of colorectal cancer. J Clin Oncol. 2003;21(20):3737–43.

    Article  Google Scholar 

  7. Jayne DG, Fook S, Loi C, Seow-Choen F. Peritoneal carcinomatosis from colorectal cancer. Br J Surg. 2002;89(12):1545–50.

    Article  CAS  Google Scholar 

  8. Koppe MJ, Boerman OC, Oyen WJ, Bleichrodt RP. Peritoneal carcinomatosis of colorectal origin: incidence and current treatment strategies. Ann Surg. Feb 2006;243(2):212-222.

    Article  Google Scholar 

  9. Baguena G, Pellino G, Frasson M, et al. Prognostic impact of pT stage and peritoneal invasion in locally advanced colon cancer. Dis Colon Rectum. 2019;62(6):684–93.

    Article  Google Scholar 

  10. Enblad M, Graf W, Birgisson H. Risk factors for appendiceal and colorectal peritoneal metastases. Eur J Surg Oncol. 2018;44(7):997–1005.

    Article  Google Scholar 

  11. Hugen N, van de Velde CJ, de Wilt JH, Nagtegaal ID. Metastatic pattern in colorectal cancer is strongly influenced by histological subtype. Ann Oncol. 2014;25(3):651–7.

    Article  CAS  Google Scholar 

  12. Leung V, Huang N, Liauw W, Morris DL. High risk features of primary colorectal carcinomas which subsequently undergo peritonectomy. Eur J Surg Oncol. Jun 2016;42(6):836-840.

    Article  CAS  Google Scholar 

  13. Tajiri K, Sudou T, Fujita F, Hisaka T, Kinugasa T, Akagi Y. Clinicopathological and corresponding genetic features of colorectal signet ring cell carcinoma. Anticancer Res. 2017;37(7):3817–23.

    CAS  PubMed  Google Scholar 

  14. Mayanagi S, Kashiwabara K, Honda M, et al. Risk factors for peritoneal recurrence in stage II to III colon cancer. Dis Colon Rectum. 2018;61(7):803–8.

    Article  Google Scholar 

  15. Nagata H, Ishihara S, Hata K, et al. Survival and prognostic factors for metachronous peritoneal metastasis in patients with colon cancer. Ann Surg Oncol. May 2017;24(5):1269-1280.

    Article  Google Scholar 

  16. Klaver CEL, Wisselink DD, Punt CJA, et al. Adjuvant hyperthermic intraperitoneal chemotherapy in patients with locally advanced colon cancer (COLOPEC): a multicentre, open-label, randomised trial. Lancet Gastroenterol Hepatol. 2019;4(10):761–70.

    Article  Google Scholar 

  17. Andre T, Boni C, Mounedji-Boudiaf L, et al. Oxaliplatin, fluorouracil, and leucovorin as adjuvant treatment for colon cancer. N Engl J Med. Jun 3 2004;350(23):2343-2351.

    Article  CAS  Google Scholar 

  18. Andre T, Boni C, Navarro M, et al. Improved overall survival with oxaliplatin, fluorouracil, and leucovorin as adjuvant treatment in stage II or III colon cancer in the MOSAIC trial. J Clin Oncol. 2009;27(19):3109–16.

    Article  CAS  Google Scholar 

  19. Goere D, Glehen O, Quenet F, et al. Results of a randomized phase 3 study evaluating the potential benefit of a second-look surgery plus HIPEC in patients at high risk of developing colorectal peritoneal metastases (PROPHYLOCHIP- NTC01226394). J Clin Oncol. 2018;36(15_suppl):3531.

    Article  Google Scholar 

  20. Bastiaenen VP, Klaver CEL, Kok NFM, et al. Second and third look laparoscopy in pT4 colon cancer patients for early detection of peritoneal metastases; the COLOPEC 2 randomized multicentre trial. BMC Cancer. 2019;19(1):254.

    Article  Google Scholar 

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Authors and Affiliations

  1. Department of Surgery, Division of Surgical Oncology, Loma Linda University Health, Loma Linda, CA, USA

    Audrey H. Choi MD, Mei Li M. Kwong MD & Matthew J. Selleck DO

  2. Department of Surgery, University of California at Irvine, Orange, CA, USA

    Cyrus Farzaneh MD, Alessio Pigazzi MD, Dorna Jafari MD & Maheswari Senthil MD

  3. Loma Linda University Cancer Center, Loma Linda University Health, Loma Linda, CA, USA

    Nidhi Kejriwal & Aashna Calidas

  4. School of Medicine, Loma Linda University, Loma Linda, CA, USA

    Kathia Cordero-Caban MD, PhD & Melanie Roman BS

Authors
  1. Audrey H. Choi MD
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  2. Cyrus Farzaneh MD
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  4. Aashna Calidas
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  5. Kathia Cordero-Caban MD, PhD
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  7. Mei Li M. Kwong MD
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  8. Matthew J. Selleck DO
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  9. Alessio Pigazzi MD
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  11. Maheswari Senthil MD
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Correspondence to Maheswari Senthil MD.

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Dr. Pigazzi serves as consultant for Medtronic, Ethicon and Vioptix.

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Choi, A.H., Farzaneh, C., Kejriwal, N. et al. Rate of Peritoneal Carcinomatosis in Resected Stage II and III Colon Cancer. Ann Surg Oncol 27, 4943–4948 (2020). https://doi.org/10.1245/s10434-020-08689-y

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  • DOI: https://doi.org/10.1245/s10434-020-08689-y

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