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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 5/2017

01-05-2017 | Colorectal Cancer

Survival and Prognostic Factors for Metachronous Peritoneal Metastasis in Patients with Colon Cancer

Authors: Hiroshi Nagata, MD, Soichiro Ishihara, MD, PhD, Keisuke Hata, MD, PhD, Koji Murono, MD, PhD, Manabu Kaneko, MD, PhD, Koji Yasuda, MD, PhD, Kensuke Otani, MD, PhD, Takeshi Nishikawa, MD, PhD, Toshiaki Tanaka, MD, PhD, Tomomichi Kiyomatsu, MD, PhD, Kazushige Kawai, MD, PhD, Hiroaki Nozawa, MD, PhD, Toshiaki Watanabe, MD, PhD

Published in: Annals of Surgical Oncology | Issue 5/2017

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Abstract

Background

The clinical course of metachronous peritoneal metastasis of colorectal origin is poorly understood. In this retrospective study, we aimed to elucidate survival and prognostic factors for metachronous peritoneal metastasis.

Methods

Patients with metachronous peritoneal metastasis after curative resection for stage I–III colon cancer were retrospectively reviewed, and the incidence and prognosis of metachronous peritoneal metastasis were investigated. Prognostic factors were identified by univariate and multivariate analyses.

Results

Among 1582 surgically resected stage I–III colon cancer patients, 65 developed metachronous peritoneal metastasis. The 5-year cumulative incidence rate was 4.5%, and the median survival after diagnosis of peritoneal metastasis was 29.6 months. None of the patients underwent peritonectomy or intraperitoneal chemotherapy. Independent prognostic factors included right colon cancer [hazard ratio (HR) 2.69, 95% confidence interval (CI) 1.26–5.64; p = 0.011], time to metachronous peritoneal metastasis of <1 year (HR 2.02, 95% CI 1.04–3.87; p = 0.040), Peritoneal Cancer Index (PCI) >10 (HR 3.68, 95% CI 1.37–8.99; p = 0.012), concurrent metastases (HR 4.09, 95% CI 2.02–8.23; p < 0.001), and peritoneal nodule resection (HR 0.31, 95% CI 0.13–0.65; p = 0.002).

Conclusions

A proportion of colon cancer patients with metachronous peritoneal metastasis may benefit from combined peritoneal nodule resection and systemic chemotherapy. Right colon cancer, early peritoneal metastasis, a high PCI, and concurrent metastases negatively affected prognosis in patients with metachronous peritoneal metastasis.
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Metadata
Title
Survival and Prognostic Factors for Metachronous Peritoneal Metastasis in Patients with Colon Cancer
Authors
Hiroshi Nagata, MD
Soichiro Ishihara, MD, PhD
Keisuke Hata, MD, PhD
Koji Murono, MD, PhD
Manabu Kaneko, MD, PhD
Koji Yasuda, MD, PhD
Kensuke Otani, MD, PhD
Takeshi Nishikawa, MD, PhD
Toshiaki Tanaka, MD, PhD
Tomomichi Kiyomatsu, MD, PhD
Kazushige Kawai, MD, PhD
Hiroaki Nozawa, MD, PhD
Toshiaki Watanabe, MD, PhD
Publication date
01-05-2017
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 5/2017
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-016-5732-z

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