| Autor: |
Cerdán-Santacruz, C., Cano-Valderrama, Ó., Peña Ros, E., Serrano del Moral, Á., Pereira Pérez, F., Flor Lorente, B., Biondo, S., Collaborating group for the study of metachronous peritoneal metastases of pT4 colon cancer, Rihuete Caro, Cristina, Jiménez de los Galanes Marchán, Santos, Fernández López, Fernando, Paz Novo, Manuel, Blanco Antona, Francisco, Noguera Aguilar, José Francisco, Taboada Ameneiro, María, Moncada Iribarren, Enrique, Aldrey Cao, Inés, Núñez Fernández, Sandra, Villarejo, Pedro, Guadalajara Labajo, Héctor |
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| Zdroj: |
Techniques in Coloproctology; Nov2023, Vol. 27 Issue 11, p1025-1036, 12p |
| Abstrakt: |
Purpose: Metachronous peritoneal metastases (MPM) following a curative surgery procedure for pT4 colon cancer is a challenging condition. Current epidemiological studies on this topic are scarce. Methods: A retrospective multicentre trial was designed. All consecutive patients who underwent operations to treat pT4 cancers between 2015 and 2017 were reviewed. Demographic, clinical, operative, pathological and oncological follow-up variables were included. MPM were described as any oncological disease at the peritoneum, clearly different from a local recurrence. Univariate and multivariate Cox regression models were constructed. A risk stratification model was created on a cumulative factor basis. According to the calculated hazard ratio (HR), a scoring system was designed (HR < 3, 1 point; HR > 3, 2 points) and a scale from 0 to 6 was calculated for peritoneal disease-free rate (PDF-R). A risk stratification model was also created on the basis of these calculations. Results: Fifty different hospitals were involved, which included a total of 1356 patients. Incidence of MPM was 13.6% at 50 months median follow-up. The strongest independent risk factors for MPM were positive pN stage [HR 3.72 (95% CI 2.56–5.41; p < 0.01) for stage III disease], tumour perforation [HR 1.91 (95% CI 1.26–2.87; p < 0.01)], mucinous or signet ring cell histology [HR 1.68 (95% CI 1.1–2.58; p = 0.02)], poorly differentiated tumours [HR 1.54 (95% CI 1.1–2.2; p = 0.02)] and emergency surgery [HR 1.42 (95% CI 1.01–2.01; p = 0.049)]. In the absence of additional risk factors, pT4 tumours showed 98% and 96% PDF-R in 1-year and 5-year periods based on Kaplan–Meier curves. Conclusions: Cumulative MPM incidence was 13.6% at 5-year follow-up. The sole presence of a pT4 tumour resulted in high rates of PDF-R at 1-year and 5-year follow-up (98% and 96% respectively). Five additional risk factors different from pT4 status itself were identified as possible MPM indicators during follow-up. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
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