The impact of radiological retroperitoneal lymphadenopathy on survival after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for colorectal peritoneal metastases

被引：3

作者：

van der Werf, L. R. ^{[1
]}

Wassenaar, E. ^{[2
]}

de Niet, A. ^{[1
]}

Lalezari, F. ^{[3
]}

Braam, H. J. ^{[4
]}

van Ramshorst, B. ^{[2
]}

Nederend, J. ^{[5
]}

de Hingh, I. H. J. T. ^{[4
]}

Kok, N. F. M. ^{[1
]}

Aalbers, A. G. J. ^{[1
]}

机构：

[1] Netherlands Canc Inst Antoni van Leeuwenhoek, Dept Surg Oncol, POB 90203, NL-1006 BE Amsterdam, Netherlands

[2] Antonius Hosp, Dept Surg Oncol, Nieuwegein, Netherlands

[3] Netherlands Canc Inst Antoni van Leeuwenhoek, Dept Radiol, Amsterdam, Netherlands

[4] Catharina Hosp, Dept Surg Oncol, Eindhoven, Netherlands

[5] Catharina Hosp, Dept Radiol, Eindhoven, Netherlands

来源：

EJSO | 2019年 / 45卷 / 03期

关键词：

Retroperitoneal lymphadenopathy; Hipec; peritoneal metastases; Retroperitoneal lymph nodes; CRS-HIPEC; SYSTEMIC CHEMOTHERAPY; RANDOMIZED-TRIAL; LYMPH-NODES; CARCINOMATOSIS; HIPEC; CANCER; MALIGNANCIES; CRITERIA; NOMOGRAM; ORIGIN;

D O I：

10.1016/j.ejso.2018.10.540

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Objectives: To investigate the impact of retroperitoneal lymphadenopathy (RPLP) on pre-operative CT scan on overall survival (OS) and disease-free survival (DFS) after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) for peritoneal metastases (PM) of colorectal cancer. Background: In patients with PM enlarged retroperitoneal lymph nodes (RPLP) are usually considered extra-regional lymph node metastases and therefore these patients may be excluded from CRS-HIPEC. This is a clinical dilemma since it is often hard to obtain histology from these nodes. Methods: In this multicenter, retrospective study all consecutive patients with colorectal PM treated with CRS-HIPEC between 2004 and 2013 were included. The preoperative CT-scan was re-analyzed for the presence of RPLP based on the radiological appearance of enlarged lymph nodes. Outcomes were OS and DFS. Kaplan-Meier methods and Cox regression modeling were used to analyze the impact of RPLP on OS and DFS. Results: In 25 of 401 patients (6.1%) RPLP was observed on the preoperative CT-scan. Patient, tumor and surgical characteristics did not statistically significantly differ between groups with and without RPLP. After a median follow-up of 46 months, the one-, three- and five-year survival was 80%, 59%, 38% and 90%, 50%, 36% in the group with and without RPLP respectively. Median OS (47 vs. 35 months, logrank: p = 0.70) and median DFS (14 vs. 15 months, logrank: p = 0.81) did not statistically significantly differ between groups. In multivariable analysis, RPLP did not significantly influence survival. Conclusion: Enlarged retroperitoneal lymph nodes on a pre-operative CT-scan should not automatically exclude patients from CRS-HIPEC. (C) 2018 Elsevier Ltd, BASO similar to The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.

引用

页码：376 / 382

页数：7

共 20 条

[1] Cytoreductive surgery and HIPEC for peritoneal metastases combined with curative treatment of colorectal liver metastases Systematic review of all literature and meta-analysis of observational studies [J].

de Cuba, E. M. V. ;

Kwakman, R. ;

Knol, D. L. ;

Bonjer, H. J. ;

Meijer, G. A. ;

te Velde, E. A. .

CANCER TREATMENT REVIEWS, 2013, 39 (04) :321-327

[2] Quality-of-Life Evaluation After Cytoreductive Surgery with Hyperthermic Intraperitoneal Chemotherapy [J].

Dodson, Rebecca M. ;

McQuellon, Richard P. ;

Mogal, Harveshp D. ;

Duckworth, Katharine E. ;

Russell, Gregory B. ;

Votanopoulos, Konstantinos I. ;

Shen, Perry ;

Levine, Edward A. .

ANNALS OF SURGICAL ONCOLOGY, 2016, 23 :S772-S783

[3] UPPER ABDOMINAL LYMPH-NODES - CRITERIA FOR NORMAL SIZE DETERMINED WITH CT [J].

DORFMAN, RE ;

ALPERN, MB ;

GROSS, BH ;

SANDLER, MA .

RADIOLOGY, 1991, 180 (02) :319-322

[4] Modified selection criteria for complete cytoreductive surgery plus HIPEC based on peritoneal cancer index and small bowel involvement for peritoneal carcinomatosis of colorectal origin [J].

Elias, D. ;

Mariani, A. ;

Cloutier, A. -S. ;

Blot, F. ;

Goere, D. ;

Dumont, F. ;

Honore, C. ;

Billard, V. ;

Dartigues, P. ;

Ducreux, M. .

EJSO, 2014, 40 (11) :1467-1473

[5] A Simple Tumor Load-Based Nomogram for Surgery in Patients with Colorectal Liver and Peritoneal Metastases [J].

Elias, Dominique ;

Faron, Matthieu ;

Goere, Diane ;

Dumont, Frederic ;

Honore, Charles ;

Boige, Valerie ;

Malka, David ;

Ducreux, Michel .

ANNALS OF SURGICAL ONCOLOGY, 2014, 21 (06) :2052-2058

[6] Retroperitoneal nodal metastases from colorectal cancer: Curable metastases with radical retroperitoneal lymphadenectomy in selected patients [J].

Gagniere, J. ;

Dupre, A. ;

Chabaud, S. ;

Peyrat, P. ;

Meeus, P. ;

Rivoire, M. .

EJSO, 2015, 41 (06) :731-737

[7] Operative Salvage for Retroperitoneal Nodal Recurrence in Colorectal Cancer: A Systematic Review [J].

Ho, Thomas WaiThong ;

Mack, Lloyd A. ;

Temple, Walley J. .

ANNALS OF SURGICAL ONCOLOGY, 2011, 18 (03) :697-703

[8] Implementation of a Standardized HIPEC Protocol Improves Outcome for Peritoneal Malignancy [J].

Kuijpers, Anke M. J. ;

Aalbers, Arend G. J. ;

Nienhuijs, Simon W. ;

de Hingh, Ignace H. J. T. ;

Wiezer, Marinus J. ;

van Ramshorst, Bert ;

van Ginkel, Robert J. ;

Havenga, Klaas ;

Heemsbergen, Wilma D. ;

Hauptmann, Michael ;

Verwaal, Victor J. .

WORLD JOURNAL OF SURGERY, 2015, 39 (02) :453-460

[9] Cytoreduction and HIPEC in The Netherlands: Nationwide Long-term Outcome Following the Dutch Protocol [J].

Kuijpers, Anke M. J. ;

Mirck, Boj ;

Aalbers, Arend G. J. ;

Nienhuijs, Simon W. ;

de Hingh, Ignace H. J. T. ;

Wiezer, Martinus J. ;

van Ramshorst, Bert ;

van Ginkel, Robert J. ;

Havenga, Klaas ;

Bremers, Andreas J. ;

de Wilt, Johannes H. W. ;

te Velde, Elisabeth A. ;

Verwaal, Vic J. .

ANNALS OF SURGICAL ONCOLOGY, 2013, 20 (13) :4224-4230

[10] Cytoreductive surgery followed by intraperitoneal hyperthermic perfusion - Analysis of morbidity and mortality in 209 peritoneal surface malignancies treated with closed abdomen technique [J].

Kusamura, S ;

Younan, R ;

Baratti, D ;

Costanzo, P ;

Favaro, M ;

Gavazzi, C ;

Deraco, M .

CANCER, 2006, 106 (05) :1144-1153

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