Risk of metachronous peritoneal metastases in patients with pT4a versus pT4b colon cancer: An international multicentre cohort study

Autor: Bastiaenen, Vp, Aalbers, Agj, Alvaro, A, Vittoria, B, van der Bilt, Jdw, D'Hoore, Ad, Esther, E, Klaver, Cel, Nagtegaal, Id, Bert van Ramshorst, van Santvoort, Hc, Sica, Gs, Petur, S, Wasmann, Katgm, de Wilt, Jhw, Wolthuis, Am, Tanis, Pj, Sica, G
Přispěvatelé: Graduate School, CCA - Cancer Treatment and Quality of Life, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, Gastroenterology and Hepatology, Surgery, CCA - Imaging and biomarkers
Rok vydání: 2021
Předmět:
Male
Internationality
Survival
Colorectal cancer
SURGERY
CARCINOMATOSIS
Gastroenterology
COLORECTAL-CANCER
Cohort Studies
Tumours of the digestive tract Radboud Institute for Health Sciences [Radboudumc 14]
0302 clinical medicine
Risk Factors
Tumours of the digestive tract Radboud Institute for Molecular Life Sciences [Radboudumc 14]
Medicine
EPIDEMIOLOGY
Oncological outcomes
Abscess
Peritoneal Neoplasms
Signet ring cell
General Medicine
Middle Aged
CHEMOTHERAPY
Neoadjuvant Therapy
Survival Rate
Oncology
Chemotherapy
Adjuvant
030220 oncology & carcinogenesis
Colonic Neoplasms
Female
030211 gastroenterology & hepatology
Life Sciences & Biomedicine
Colon
Transverse
Cohort study
medicine.medical_specialty
Abdominal Abscess
Adenocarcinoma
Disease-Free Survival
Locally advanced colon cancer
Colon
Ascending
03 medical and health sciences
All institutes and research themes of the Radboud University Medical Center
Sex Factors
Internal medicine
Humans
Surgical Wound Infection
Neoplasm Invasiveness
In patient
T4 colon cancer
Aged
Neoplasm Staging
Science & Technology
business.industry
Proportional hazards model
Cancer
Histology
medicine.disease
Settore MED/18
Peritoneal metastases
CURATIVE TREATMENT
Surgery
Neoplasm Recurrence
Local
business
Carcinoma
Signet Ring Cell
Zdroj: European Journal of Surgical Oncology, 47, 2405-2413
European journal of surgical oncology, 47(9), 2405-2413. W.B. Saunders Ltd
European Journal of Surgical Oncology, 47, 9, pp. 2405-2413
ISSN: 0748-7983
Popis: INTRODUCTION: With evolving treatment strategies aiming at prevention or early detection of metachronous peritoneal metastases (PM), identification of high-risk colon cancer patients becomes increasingly important. This study aimed to evaluate differences between pT4a (peritoneal penetration) and pT4b (invasion of other organs/structures) subcategories regarding risk of PM and other oncological outcomes. MATERIALS AND METHODS: From eight databases deriving from four countries, patients who underwent curative intent treatment for pT4N0-2M0 primary colon cancer were included. Primary outcome was the 5-year metachronous PM rate assessed by Kaplan-Meier analysis. Independent predictors for metachronous PM were identified by Cox regression analysis. Secondary endpoints included 5-year local and distant recurrence rates, and 5-year disease free and overall survival (DFS, OS). RESULTS: In total, 665 patients with pT4a and 187 patients with pT4b colon cancer were included. Median follow-up was 38 months (IQR 23-60). Five-year PM rate was 24.7% and 12.2% for pT4a and pT4b categories, respectively (p = 0.005). Independent predictors for metachronous PM were female sex, right-sided colon cancer, peritumoral abscess, pT4a, pN2, R1 resection, signet ring cell histology and postoperative surgical site infections. Five-year local recurrence rate was 14% in both pT4a and pT4b cancer (p = 0.138). Corresponding five-year distant metastases rates were 35% and 28% (p = 0.138). Five-year DFS and OS were 54% vs. 62% (p = 0.095) and 63% vs. 68% (p = 0.148) for pT4a vs. pT4b categories, respectively. CONCLUSION: Patients with pT4a colon cancer have a higher risk of metachronous PM than pT4b patients. This observation has important implications for early detection and future adjuvant treatment strategies. ispartof: EJSO vol:47 issue:9 pages:2405-2413 ispartof: location:England status: published
Databáze: OpenAIRE
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