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Prognostic factors for peritoneal carcinomatosis originating from colorectal cancer: an analysis of 921 patients from a multi-institutional database

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Abstract

Purpose

The purpose of this study was to clarify the factors affecting R0 resection and the prognosis of patients with peritoneal carcinomatosis (PC) from colorectal cancer (CRC) in the Japanese population.

Methods

A multi-institutional retrospective analysis of 921 patients who underwent surgery between 1991 and 2007 for CRC with PC was conducted. Clinicopathological variables were analyzed for prognostic significance. A multivariate analysis using a Cox regression modeling was performed to assess the prognostic value of the variables.

Results

The median survival time of all patients was 14.3 months (range 0–209 months) and the 5-year overall survival rate was 9.7 %. The multivariate analysis revealed that a lymph node status of pN0/1, the absence of blood-born metastasis, R0 resection and adjuvant chemotherapy favorably affected the survival. Furthermore, the completion of R0 resection was significantly affected by the preoperative serum CEA level, the presence of blood-born metastasis and the grade of PC. The 5-year overall survival and median survival time of the patients with four favorable prognostic factors, namely pN0/1, the absence of blood-born metastasis, R0 resection and adjuvant chemotherapy, were significantly better than those of the remaining patients (37.1 vs. 7.2 % and 37.0 vs. 13.3 months, respectively; p < 0.0001).

Conclusions

Although few patients with PC from CRC survive for more than 5 years, performing R0 resection with curative intent in association with postoperative adjuvant chemotherapy should be considered in appropriately selected patients.

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Acknowledgments

This paper was presented on behalf of the project team of the Japanese Society for Cancer of the Colon and Rectum. The authors thank the following institutional investigators for collecting the patient data: K. Hase, MD, Department of Surgery, National Defense Medical College; S. Kameoka, MD, Department of Surgery II, Tokyo Women’s Medical University; H. Yano, MD, Department of Surgery, National Center for Global Health and Medicine; K. Takahashi, MD, Department of Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital; Y. Hashiguchi, MD, Department of Surgery, Teikyo University School of Medicine; T. Watanabe, MD, Department of Surgical Oncology, University of Tokyo; K. Maeda, MD, Department of Surgery, Fujita Health University; K. Komori, MD, Department of Gastroenterological Surgery, Aichi Cancer Center Hospital; K. Shirouzu, MD, Department of Surgery, Faculty of Medicine, Kurume University; K. Hirata, MD, First Department of Surgery, Sapporo Medical University; T. Morita, MD, Cancer Center, Aomori Prefectural Central Hospital; K. Hunahashi, MD, Department of Surgery, Toho University; M. Ohue, MD, Department of Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases; T. Yatsuoka, MD, Department of Gastroenterological Surgery, Saitama Cancer Center; T. Iiai, MD, Department of Surgery, Niigata University.

Conflict of interest

Ozawa and co-authors have no conflicts of interest to declare.

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Authors and Affiliations

  1. Department of Surgery, Tochigi Cancer Center, 4-9-13 Yonan, Utsunomiya, Tochigi, 320-0834, Japan

    Heita Ozawa & Kenjiro Kotake

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

    Hirotoshi Kobayashi & Kenichi Sugihara

Authors
  1. Heita Ozawa
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  2. Kenjiro Kotake
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  3. Hirotoshi Kobayashi
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  4. Kenichi Sugihara
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Corresponding author

Correspondence to Heita Ozawa.

Additional information

Study Group for Peritoneal Metastasis from Colorectal Cancer by the Japanese Society for Cancer of the Colon and Rectum.

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Ozawa, H., Kotake, K., Kobayashi, H. et al. Prognostic factors for peritoneal carcinomatosis originating from colorectal cancer: an analysis of 921 patients from a multi-institutional database. Surg Today 44, 1643–1650 (2014). https://doi.org/10.1007/s00595-013-0735-x

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  • DOI: https://doi.org/10.1007/s00595-013-0735-x

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