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

  • Original Article—Alimentary Tract
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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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Conflict of interest

All authors declare that there is no conflict of interest in this manuscript.

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Authors and Affiliations

  1. Center for Minimally Invasive Surgery, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan

    Hirotoshi Kobayashi

  2. Department of Surgical Oncology, Tokyo Medical and Dental University, Tokyo, Japan

    Hirotoshi Kobayashi & Kenichi Sugihara

  3. Department of Surgery, Tochigi Cancer Center, Utsunomiya, Japan

    Kenjiro Kotake

  4. Department of Surgery, Toho University, Tokyo, Japan

    Kimihiko Funahashi

  5. Department of Surgery, National Defense Medical College, Tokorozawa, Japan

    Kazuo Hase

  6. First Department of Surgery, Sapporo Medical University, Sapporo, Japan

    Koichi Hirata

  7. Department of Surgery, Niigata University, Niigata, Japan

    Tsuneo Iiai

  8. Second Department of Surgery, Tokyo Women’s Medical University, Tokyo, Japan

    Shingo Kameoka

  9. Department of Surgery, Aichi Cancer Center, Nagoya, Japan

    Yukihide Kanemitsu

  10. Department of Surgery, Fujita Health University, Toyoake, Japan

    Koutarou Maeda

  11. Department of Surgery, Hirosaki University, Hirosaki, Japan

    Akihiko Murata

  12. Department of Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan

    Masayuki Ohue

  13. Department of Surgery, Kurume University, Kurume, Japan

    Kazuo Shirouzu

  14. Department of Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan

    Keiichi Takahashi

  15. Department of Surgical Oncology, University of Tokyo, Tokyo, Japan

    Toshiaki Watanabe

  16. Department of Surgery, National Center for Global Health and Medicine, Tokyo, Japan

    Hideaki Yano

  17. Department of Surgery, Saitama Cancer Center, Saitama, Japan

    Toshimasa Yatsuoka

  18. Department of Surgery, Teikyo University, Tokyo, Japan

    Yojiro Hashiguchi

Authors
  1. Hirotoshi Kobayashi
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  2. Kenjiro Kotake
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  3. Kimihiko Funahashi
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  4. Kazuo Hase
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  5. Koichi Hirata
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  16. Toshimasa Yatsuoka
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  17. Yojiro Hashiguchi
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  18. Kenichi Sugihara
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Study Group for Peritoneal Metastasis from Colorectal Cancer by the Japanese Society for Cancer of the Colon and Rectum

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Correspondence to Hirotoshi Kobayashi.

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Kobayashi, H., Kotake, K., Funahashi, K. et al. Clinical benefit of surgery for stage IV colorectal cancer with synchronous peritoneal metastasis. J Gastroenterol 49, 646–654 (2014). https://doi.org/10.1007/s00535-013-0820-3

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  • DOI: https://doi.org/10.1007/s00535-013-0820-3

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