Factors Affecting the Prognosis after Primary Tumor Resection for Patients with Metastatic Colorectal Cancer with Synchronous Peritoneal Metastasis: A Multi-center, Prospective, Observational Study

被引：0

作者：

Kagami, Satoru ^{[1
]}

Funahashi, Kimihiko ^{[1
]}

Kobayashi, Hirotoshi ^{[2
,3
]}

Kotake, Kenjiro ^{[4
]}

Kawasaki, Masayasu ^{[5
]}

Kinugasa, Yusuke ^{[6
]}

Ueno, Hideki ^{[7
]}

Maeda, Kotaro ^{[8
]}

Suto, Takeshi ^{[9
]}

Itabashi, Michio ^{[10
]}

Ozawa, Heita ^{[11
]}

Koyama, Fumikazu ^{[12
,13
]}

Noura, Shingo ^{[14
]}

Ishida, Hideyuki ^{[15
]}

Ohue, Masayuki ^{[16
]}

Kiyomatsu, Tomomichi ^{[17
]}

Ishihara, Soichiro ^{[18
]}

Koda, Keiji ^{[19
]}

Baba, Hideo ^{[20
]}

Kawada, Kenji ^{[21
,22
]}

Hashiguchi, Yojiro ^{[23
]}

Goi, Takanori ^{[24
]}

Toiyama, Yuji ^{[25
]}

Tomita, Naohiro ^{[26
]}

Sunami, Eiji ^{[27
]}

Fujita, Fumihiko ^{[28
]}

Watanabe, Jun ^{[29
]}

Hakamada, Kenichi ^{[30
]}

Nakayama, Goro ^{[31
]}

Sugihara, Kenichi ^{[32
]}

Ajioka, Yoichi ^{[33
]}

机构：

[1] Toho Univ, Omori Med Ctr, Dept Gen & Gastroenterol Surg, Tokyo, Japan

[2] Tokyo Metropolitan Hiroo Gen Hosp, Dept Surg, Tokyo, Japan

[3] Teikyo Univ Hosp, Dept Surg, Mizonokuchi, Kanagawa, Japan

[4] Sano City Hosp, Dept Surg, Sano City, Tochigi, Japan

[5] Bell Land Gen Hosp, Dept Surg, Sakai, Japan

[6] Inst Sci Tokyo, Dept Gastrointestinal Surg, Tokyo, Japan

[7] Natl Def Med Coll, Dept Surg, Tokorozawa, Japan

[8] Fujita Hlth Univ Hosp, Int Med Ctr, Toyoake, Japan

[9] Yamagata Prefectural Cent Hosp, Dept Surg Gastroenterol, Yamagata, Japan

[10] Tokyo Womens Med Univ, Inst Gastroenterol, Dept Surg, Tokyo, Japan

[11] Tochigi Canc Ctr, Dept Surg, Utsunomiya, Japan

[12] Nara Med Univ, Dept Surg, Kashihara, Japan

[13] Nara Med Univ, Div Endoscopy, Kashihara, Japan

[14] Osaka Rosai Hosp, Dept Surg, Sakai, Osaka, Japan

[15] Saitama Med Univ, Saitama Med Ctr, Dept Digest Tract & Gen Surg, Kawagoe, Saitama, Japan

[16] Osaka Int Canc Inst, Dept Surg Gastroenterol, Osaka, Japan

[17] Natl Ctr Global Hlth & Med, Dept Colorectal Surg, Tokyo, Japan

[18] Univ Tokyo Hosp, Dept Surg Oncol, Tokyo, Japan

[19] Teikyo Univ, Chiba Med Ctr, Ichihara, Chiba, Japan

[20] Kumamoto Univ, Grad Sch Med Sci, Dept Surg Gastroenterol, Kumamoto, Japan

[21] Kyoto Univ, Grad Sch Med, Dept Gastrointestinal Surg, Kyoto, Japan

[22] Kurashiki Cent Hosp, Dept Surg, Kurashiki, Okayama, Japan

[23] Teikyo Univ, Sch Med, Dept Surg, Tokyo, Japan

[24] Univ Fukui, Dept Surg 1, Fukui, Japan

[25] Mie Univ, Inst Life Sci, Dept Gastrointestinal & Pediat Surg, Div Reparat Med,Grad Sch Med, Tsu, Mie, Japan

[26] Hyogo Med Univ, Dept Surg Gastroenterol, Div Lower Gastrointestinal Surg, Nishinomiya, Hyogo, Japan

[27] Kyorin Univ, Sch Med, Dept Surg, Tokyo, Japan

[28] Kurume Univ, Sch Med, Dept Surg, Kurume, Fukuoka, Japan

[29] Kansai Med Univ, Dept Colorectal Surg, Osaka, Japan

[30] Hirosaki Univ, Grad Sch Med, Dept Gastroenterol Surg, Aomori, Japan

[31] Nagoya Univ, Grad Sch Med, Dept Gastroenterol Surg Surg 2, Nagoya, Japan

[32] Inst Sci Tokyo, Tokyo, Japan

[33] Niigata Univ, Grad Sch Med & Dent Sci, Div Mol & Diagnost Pathol, Niigata, Japan

来源：

JOURNAL OF THE ANUS RECTUM AND COLON | 2025年 / 9卷 / 01期

关键词：

colorectal cancer; primary tumor resection; prognosis; synchronous peritoneal metastasis; JAPANESE CLASSIFICATION; CYTOREDUCTIVE SURGERY; INTRAPERITONEAL CHEMOTHERAPY; RANDOMIZED-TRIALS; R0; RESECTION; CARCINOMATOSIS; BENEFIT; SURVIVAL; OUTCOMES;

D O I：

10.23922/jarc.2024-056

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Objectives: To clarify the risk factors affecting prognosis after primary tumor resection (PTR) in patients with metastatic colorectal cancer with synchronous peritoneal metastasis (mCRC-SPM). Methods: Patients were enrolled prospectively in the JSCCR project "Grading of Peritoneal Seeding in Colorectal Cancer." Factors that may influence overall survival & horbar;age, sex, location of the primary tumor, lymph node metastasis, presence of liver metastasis, degree of peritoneal metastasis, peritoneal cancer index (PCI), cancer cure, and postoperative chemotherapy & horbar;in the PTR group were examined using multivariate analysis. Results: Of the 133 enrolled patients with mCRC-SPM, 112 patients underwent PTR. Among them, 26 (23.2%) had mCRC-SPM of grade P1, 47 (42.0%) of P2, and 39 (34.8%) of P3. The median PCI was 4 (range, 1-28); no surgery-related deaths occurred. Postoperative complications of Clavien-Dindo classification >= grade 2 were observed in 20 (17.9%) patients. R0 surgery became more difficult as the degree of dissemination increased, and the PTR group had a significantly better prognosis than the non-PTR group. In the multivariate analysis, age >= 75 years, rectal cancer, presence of liver metastasis, higher PCI, non-curative resection, and non-treatment with systemic chemotherapy were associated with poor prognosis in patients after PTR. Conclusions: In patients with mCRC-SPM, postoperative complications are infrequent for P1 with localized peritoneal dissemination, and PTR may be considered as aggressive treatment. Factors including age >= 75 years, rectal cancer, presence of liver metastasis, increased PCI, non-curative resection, and non- treatment with systemic chemotherapy are associated with a reduced survival benefit from PTR.

引用

页码：134 / 144

页数：11

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