Risk factors for appendiceal and colorectal peritoneal metastases

Autor: Malin Enblad, Wilhelm Graf, Helgi Birgisson
Rok vydání: 2018
Předmět:
Male
Colorectal cancer
medicine.medical_treatment
Perineural invasion
Disease
030230 surgery
Gastroenterology
0302 clinical medicine
Left colon
Risk Factors
Cumulative incidence
Registries
Digestive System Surgical Procedures
Peritoneal Neoplasms
Aged
80 and over
Age Factors
Cytoreduction Surgical Procedures
General Medicine
Bowel resection
Middle Aged
Adenocarcinoma
Mucinous
Colon
Descending
Appendiceal Neoplasms
Oncology
030220 oncology & carcinogenesis
Colonic Neoplasms
Female
Colorectal Neoplasms
medicine.medical_specialty
Adenocarcinoma
Colon
Ascending
03 medical and health sciences
Sex Factors
Internal medicine
medicine
Humans
Neoplasm Invasiveness
Aged
Neoplasm Staging
Proportional Hazards Models
Sweden
Rectal Neoplasms
business.industry
Cancer
medicine.disease
Logistic Models
Multivariate Analysis
Surgery
Histopathology
Lymph Nodes
Emergencies
business
Zdroj: European Journal of Surgical Oncology. 44:997-1005
ISSN: 0748-7983
2007-2015
Popis: Early diagnosis to target minimal volume disease has received increased attention in the management of appendiceal and colorectal peritoneal metastases (PM). This study aimed to identify risk factors for appendiceal, colon and rectal PM.Data were retrieved from the Swedish Colorectal Cancer Registry for all patients undergoing bowel resection of appendiceal and colorectal tumours, in Sweden, 2007-2015. Risk factors for synchronous and metachronous PM were analysed with multivariate logistic and Cox proportional hazard regression models.Synchronous PM was most common in appendiceal cancer (23.5%), followed by colon (3.1%) and rectal (0.6%) cancer. The 5-year cumulative incidence was 9.0% for appendiceal, 2.5% for right colon, 1.8% for left colon and 1.2% for rectal cancer. In appendiceal cancer (n = 327), T4, N2, mucinous tumour, and non-radical surgery were associated with PM. In colon cancer (n = 24,399), synchronous PM were primarily associated with T4 (OR 18.37, 95% CI 8.12-41.53), T3 and N2 but also with N1, right-sided tumour, mucinous tumour, vascular and perineural invasion, female gender, age60 and emergency surgery. These factors were also associated with metachronous PM. In rectal cancer (n = 10,394), T4 (OR 19.12, 95% CI 5.52-66.24), proximal tumour and mucinous tumour were associated with synchronous PM and T4 and mucinous tumour with metachronous PM.This study shows that appendiceal cancer, right-sided colon cancer, advanced tumour and node stages and mucinous histopathology are the main high-risk features for PM and should increase the awareness of current or future PM.
Databáze: OpenAIRE
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