Risk Factors for Peritoneal Recurrence in Stage II to III Colon Cancer

被引：42

作者：

Mayanagi, Shuhei ^{[1
]}

Kashiwabara, Kosuke ^{[2
]}

Honda, Michitaka ^{[3
]}

Oba, Koji ^{[2
]}

Aoyama, Toru ^{[4
]}

Kanda, Mitsuro ^{[5
]}

Maeda, Hiromichi ^{[6
]}

Hamada, Chikuma ^{[7
]}

Sadahiro, Sotaro ^{[8
]}

Sakamoto, Junichi ^{[9
,10
]}

Saji, Shigetoyo ^{[10
]}

Yoshikawa, Takaki ^{[11
]}

机构：

[1] Keio Univ, Dept Surg, Sch Med, Tokyo, Japan

[2] Univ Tokyo, Grad Sch Med, Dept Biostat, Tokyo, Japan

[3] Fukushima Med Univ, Dept Minimally Invas Surg & Med Oncol, Fukushima, Japan

[4] Yokohama City Univ, Dept Surg, Yokohama, Kanagawa, Japan

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

[6] Kochi Med Sch Hosp, Canc Treatment Ctr, Kochi, Japan

[7] Tokyo Univ Sci, Fac Engn, Tokyo, Japan

[8] Tokai Univ, Dept Surg, Isehara, Kanagawa, Japan

[9] Tokai Cent Hosp, Kakamigahara, Japan

[10] Japanese Fdn Multidisciplinary Treatment Canc, Tokyo, Japan

[11] Kanagawa Canc Ctr, Dept Gastrointestinal Surg, Yokohama, Kanagawa 2418515, Japan

来源：

DISEASES OF THE COLON & RECTUM | 2018年 / 61卷 / 07期

关键词：

Colon cancer; Cytoreductive surgery; Hyperthermic intraperitoneal chemotherapy; Metachronous peritoneal carcinomatosis; Peritoneal recurrence; COLORECTAL-CANCER; ADJUVANT CHEMOTHERAPY; CURATIVE TREATMENT; CARCINOMATOSIS; METASTASES; SURVIVAL; PATTERNS; SURGERY;

D O I：

10.1097/DCR.0000000000001002

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

BACKGROUND: Most previous reports to analyze risk factors for peritoneal recurrence in patients with colon cancer have been observational studies of a population-based cohort. OBJECTIVE: This study aimed to determine the risk factors for peritoneal recurrence in patients with stage II to III colon cancer who underwent curative resection. DESIGN: This was a pooled analysis using a combined database obtained from 3 large phase III randomized trials (N = 3714). SETTINGS: Individual patient data were collected from the Japanese Foundation for Multidisciplinary Treatment of Cancer clinical trials 7, 15, and 33, which evaluated the benefits of postoperative 5-fluorouracil-based adjuvant therapies in patients with locally advanced colorectal cancer. PATIENTS: We included patients who had stage II to III colon cancer and underwent curative resection with over D2 lymph node dissection. MAIN OUTCOME MEASURES: Main outcomes measured were risk factors for peritoneal recurrence without other organ metastasis after curative surgery. RESULTS: Peritoneal recurrence occurred in 2.3% (86/3714) of all patients undergoing curative resection. Mean duration from operation to peritoneal recurrence was 17.010.3 months. Of these patients with peritoneal recurrence, 29 patients (34%) had recurrence in 1 other organ. Multivariate analysis showed that age (60 y: HR = 0.531; p = 0.0182), pathological T4 (HR = 3.802; p < 0.0001), lymph node involvement (HR = 3.491; p = 0.0002), and lymphadenectomy (D2: HR = 1.801; p = 0.0356) were independent predictors of peritoneal recurrence. The overall survival was lower in patients who developed peritoneal recurrence than in those with other recurrence (HR = 1.594; p = 0.002). LIMITATIONS: The regimens of adjuvant chemotherapy were limited to oral 5-fluorouracil. CONCLUSIONS: Our findings clarified the risk factors for peritoneal recurrence in patients who underwent curative resection for colon cancer. See Video Abstract at http://links.lww.com/DCR/A609.

引用

页码：803 / 808

页数：6

共 19 条

[1] Mucinous histology predicts for poor response rate and overall survival of patients with colorectal cancer and treated with first-line oxaliplatin- and/or irinotecan-based chemotherapy [J].