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Prognostic Factors in Patients with Synchronous Peritoneal Carcinomatosis (PC) Caused by a Primary Cancer of the Colon

  • Original Article
  • Published:
Journal of Gastrointestinal Surgery

Abstract

Background

Peritoneal carcinomatosis (PC) is seen in about 10% of patients with colon cancer during the initial operation and has been considered a preterminal condition. The actual outcome can vary extensively depending on the presence/absence of metastases other than PC.

Methods

A total of 975 consecutive patients with colon cancer who underwent resection were included. The extent of PC was determined at laparotomy. Metastases restricted to the adjacent peritoneum or a few metastases to the distant peritoneum were classified as “limited,” whereas numerous metastases to the distant peritoneum were as “extensive” regardless of the sizes of the disseminated nodules.

Results

PC group consisted of 75 patients (7.7%). The median survival time (MST) in the PC group was 6.8 months. Survival was significantly better in cases with limited PC (MST, 12.4 months), without lymph node involvement (20.8 months), with preoperative performance status of 0 or 1 (8.5 months), and who received chemotherapy more than 3 months (8.8 months). A multivariate analysis revealed that these four factors were significant predictors of better outcome.

Conclusions

The extent of PC and lymph node involvement, even if the distribution is confined around the primary lesion, are more accurate prognostic factors than distant metastasis in patients with colon cancer and synchronous PC.

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References

  1. Jemal A, Siegel, Ward E, Murray T, Xu J, Thun MJ. Cancer statistics, 2007. CA Cancer J Clin 2007;57:43–66. doi:10.3322/canjclin.57.1.43.

    Article  PubMed  Google Scholar 

  2. Ferlay J, Autier P, Boniol M, Heanue M, Colombet M, Boyle P. Estimates of the cancer incidence and mortality in Europe in 2006. Ann Oncol 2007;18:581–592. doi:10.1093/annonc/mdl498.

    Article  PubMed  CAS  Google Scholar 

  3. Galandiuk S, Wieand HS, Moetel CG, Cha SS, Fitzgibbons RJ Jr, Pemberton JH, Wolff BG. Patterns of recurrence after curative resection of carcinoma of the colon and rectum. Surg Gynecol Obstet 1992;174:27–32.

    PubMed  CAS  Google Scholar 

  4. Tominaga T, Sakabe T, Koyama Y, Hamano K, Yasutomi M, Takahashi T et al. Prognostic factors for patients with colon or rectal carcinoma treated with resection only. Five-year follow-up report. Cancer 1996;78:403–408. doi:10.1002/(SICI)1097-0142(19960801)78:3<403::AID-CNCR4>3.0.CO;2-K.

    Article  PubMed  CAS  Google Scholar 

  5. Sadahiro S, Suzuki T, Ishikawa K, Nakamura T, Tanaka Y, Masuda T et al. Recurrence patterns after curative resection of colorectal cancer in patients followed for a minimum of ten years. Hepatogastroenterology 2003;50:1362–1366.

    PubMed  Google Scholar 

  6. Brodsky JT, Cohen AM. Peritoneal seeding following potentially curative resection of colonic carcinoma: implication for adjuvant therapy. Dis Colon Rectum 1991;34:723–727. doi:10.1007/BF02050360.

    Article  PubMed  CAS  Google Scholar 

  7. Dawson LE, Russell AH, Tong D, Wisbeck WM. Adenocarcinoma of the sigmoid colon: sites of initial dissemination and clinical patterns of recurrence following surgery alone. J Surg Oncol 1983;22:95–99. doi:10.1002/jso.2930220208.

    Article  PubMed  CAS  Google Scholar 

  8. Chu DZ, Lang NP, Thompson C, Osteen PK, Westbrook KC. Peritoneal carcinomatosis in nongynecologic malignancy: a prospective study of prognostic factors. Cancer 1989;63:364–367. doi:10.1002/1097-0142(19890115)63:2<364::AID-CNCR2820630228>3.0.CO;2-V.

    Article  PubMed  CAS  Google Scholar 

  9. Russell AH, Tong D, Dawson LE, Wisbeck W. Adenocarcinoma of the proximal colon, sites of initial dissemination and patterns of recurrence following surgery alone. Cancer 1984;53:360–367. doi:10.1002/1097-0142(19840115)53:2<360::AID-CNCR2820530232>3.0.CO;2-U.

    Article  PubMed  CAS  Google Scholar 

  10. Shepherd NA, Baxter KJ, Love SB. The prognostic importance of peritoneal involvement in colonic cancer: a prospective evaluation. Gastroenterol 1997;112:1096–1102. doi:10.1016/S0016-5085(97)70119-7.

    Article  CAS  Google Scholar 

  11. Sadeghi B, Arvieux C, Glehen O, Beaujard AC, Rivoire M, Baulieux J et al. Peritoneal carcinomatosis from non-gynecologic malignancies: result of the EVOCAPE 1 multicentric prospective study. Cancer 2000;88:358–363. doi:10.1002/(SICI)1097-0142(20000115)88:2<358::AID-CNCR16>3.0.CO;2-O.

    Article  PubMed  CAS  Google Scholar 

  12. Jayne DG, Fook S, Loi C, Seow-Choen F. Peritoneal carcinomatosis from colorectal cancer. Br J Surg 2002;89:1545–1550. doi:10.1046/j.1365-2168.2002.02274.x.

    Article  PubMed  CAS  Google Scholar 

  13. Pelz JOW, Stojadinovic A, Nissan A, Hohenberger W, Esquivel J. Evaluation of a peritoneal surface disease severity score in patients with colon cancer with peritoneal carcinomatosis. J Surg Oncol 2009;99:9–15. doi:10.1002/jso.21169.

    Article  PubMed  Google Scholar 

  14. Verwaal VJ, van Ruth S, de Bree E, van Slooten GW, van Tinteren H, Boot H, Zoetmulder AN. 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;21:3737–3743. doi:10.1200/JCO.2003.04.187.

    Article  PubMed  Google Scholar 

  15. Glehen O, Kwiatkowski F, Sugarbaker PH, Elias D, Levine EA, De Simone M et al. Cytoreductive surgery combined with perioperative intraperitoneal carcinomatosis from colorectal cancer: a multi-institution study. J Clin Oncol 2004;22:3284–3292. doi:10.1200/JCO.2004.10.012.

    Article  PubMed  CAS  Google Scholar 

  16. Hurwitz H, Fehrenbacher L, Novotny W, Carwright T, Hainsworth J, Heim W et al. Bevacizumab plus irinotecan, fluorouracil, and leucovorin for metastatic colorectal cancer. N Engl J Med 2004;350:2335–2342. doi:10.1056/NEJMoa032691.

    Article  PubMed  CAS  Google Scholar 

  17. Grothey A, Sargent D, Goldberg RM, Schmoll HJ. Survival of patients with advanced colorectal cancer improves with the availability of fluorouracil-leucovorin, irinotecan, and oxaliplatin in the course of treatment. J Clin Oncol 2004;22:1209–1214. doi:10.1200/JCO.2004.11.037.

    Article  PubMed  CAS  Google Scholar 

  18. Jacquet P, Jelinek JS, Steves MA, Sugarbaker PH. Evaluation of computed tomography in patients with peritoneal carcinomatosis. Cancer 1993;72:1631–1636. doi:10.1002/1097-0142(19930901)72:5<1631::AID-CNCR2820720523>3.0.CO;2-I.

    Article  PubMed  CAS  Google Scholar 

  19. Japanese Society for Cancer of the Colon and Rectum. General rules for clinical and pathological studies on cancer of colon, rectum and anus, 7th edn. Tokyo: Kanehara shuppan, 1997.

    Google Scholar 

  20. Verwaal VJ, van Tinteren H, van Ruth S, Zoetmulder AN. Predicting the survival of patients with peritoneal carcinomatosis of colorectal original treated by aggressive cytoreduction and hyperthermic intraperitoneal chemotherapy. Br J Surg 2004;91:739–746. doi:10.1002/bjs.4516.

    Article  PubMed  CAS  Google Scholar 

  21. Gilly F, Beaujard A, Glehen O, Grandclement E, Caillot JL, Francois Y et al. Peritonectomy combined with intraperitoneal chemohyperthermia in abdominal cancer with peritoneal carcinomatosis: phase I–II study. Anticancer Res 1999;19:2317–2322.

    PubMed  CAS  Google Scholar 

  22. Jacquet P, Sugarbaker PH. Clinical research methodologies in diagnosis and staging of patients with peritoneal carcinomatosis. Cancer Treat Res 1996;82:359–374.

    PubMed  CAS  Google Scholar 

  23. Lambert LA, Mansfield PF. Cytoreductive surgery and perioperative intraperitoneal chemotherapy for colorectal carcinomatosis: if at first you don’t succeed…. Ann Surg Oncol 2007;14:3037–3039. doi:10.1245/s10434-007-9548-8.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Surgery, Tokai University, 143 Shimokasuya, Isehara, Kanagawa, 259-1193, Japan

    Sotaro Sadahiro, Toshiyuki Suzuki, Yuji Maeda, Akira Tanaka, Hiroyasu Makuuchi & Akemi Kamijo

  2. Department of Medical Engineering And Informatics, Tokai University School Of Medicine, Isehara, Kanagawa, Japan

    Yasuo Haruki

  3. Department of Clinical Pharmacology, Tokai University School of Medicine, Isehara, Kanagawa, Japan

    Chieko Murayama

Authors
  1. Sotaro Sadahiro
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  2. Toshiyuki Suzuki
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  3. Yuji Maeda
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  4. Akira Tanaka
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  5. Hiroyasu Makuuchi
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  6. Akemi Kamijo
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  7. Yasuo Haruki
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  8. Chieko Murayama
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Correspondence to Sotaro Sadahiro.

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Sadahiro, S., Suzuki, T., Maeda, Y. et al. Prognostic Factors in Patients with Synchronous Peritoneal Carcinomatosis (PC) Caused by a Primary Cancer of the Colon. J Gastrointest Surg 13, 1593–1598 (2009). https://doi.org/10.1007/s11605-009-0939-y

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  • DOI: https://doi.org/10.1007/s11605-009-0939-y

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