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Published in: Annals of Surgical Oncology 13/2020

01-12-2020 | Peritoneal Cancer | Peritoneal Surface Malignancy

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

Authors: Audrey H. Choi, MD, Cyrus Farzaneh, MD, Nidhi Kejriwal, Aashna Calidas, Kathia Cordero-Caban, MD, PhD, Melanie Roman, BS, Mei Li M. Kwong, MD, Matthew J. Selleck, DO, Alessio Pigazzi, MD, Dorna Jafari, MD, Maheswari Senthil, MD

Published in: Annals of Surgical Oncology | Issue 13/2020

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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.
Literature
1.
go back to reference 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.CrossRef 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.CrossRef
2.
go back to reference 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.CrossRef 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.CrossRef
3.
go back to reference 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.CrossRef 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.CrossRef
4.
go back to reference 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.CrossRef 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.CrossRef
5.
go back to reference 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.CrossRef 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.CrossRef
6.
go back to reference 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.CrossRef 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.CrossRef
7.
go back to reference Jayne DG, Fook S, Loi C, Seow-Choen F. Peritoneal carcinomatosis from colorectal cancer. Br J Surg. 2002;89(12):1545–50.CrossRef Jayne DG, Fook S, Loi C, Seow-Choen F. Peritoneal carcinomatosis from colorectal cancer. Br J Surg. 2002;89(12):1545–50.CrossRef
8.
go back to reference 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.CrossRef 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.CrossRef
9.
go back to reference 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.CrossRef 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.CrossRef
10.
go back to reference Enblad M, Graf W, Birgisson H. Risk factors for appendiceal and colorectal peritoneal metastases. Eur J Surg Oncol. 2018;44(7):997–1005.CrossRef Enblad M, Graf W, Birgisson H. Risk factors for appendiceal and colorectal peritoneal metastases. Eur J Surg Oncol. 2018;44(7):997–1005.CrossRef
11.
go back to reference 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.CrossRef 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.CrossRef
12.
go back to reference 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.CrossRef 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.CrossRef
13.
go back to reference 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.PubMed 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.PubMed
14.
go back to reference 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.CrossRef 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.CrossRef
15.
go back to reference 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.CrossRef 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.CrossRef
16.
go back to reference 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.CrossRef 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.CrossRef
17.
go back to reference 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.CrossRef 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.CrossRef
18.
go back to reference 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.CrossRef 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.CrossRef
19.
go back to reference 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.CrossRef 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.CrossRef
20.
go back to reference 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.CrossRef 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.CrossRef
Metadata
Title
Rate of Peritoneal Carcinomatosis in Resected Stage II and III Colon Cancer
Authors
Audrey H. Choi, MD
Cyrus Farzaneh, MD
Nidhi Kejriwal
Aashna Calidas
Kathia Cordero-Caban, MD, PhD
Melanie Roman, BS
Mei Li M. Kwong, MD
Matthew J. Selleck, DO
Alessio Pigazzi, MD
Dorna Jafari, MD
Maheswari Senthil, MD
Publication date
01-12-2020
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 13/2020
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-020-08689-y

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