Long-Term Outcomes After R0 Resection of Synchronous Peritoneal Metastasis from Colorectal Cancer Without Cytoreductive Surgery or Hyperthermic Intraperitoneal Chemotherapy

Background The National Comprehensive Cancer Network (NCCN) guidelines for colon cancer recently added the following footnote regarding the therapeutic strategy for peritoneal metastases: “If R0 resection can be achieved, surgical resection of isolated peritoneal disease may be considered at experie...

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Vydáno v:Annals of surgical oncology Ročník 25; číslo 1; s. 173 - 178
Hlavní autoři: Shida, Dai, Tsukamoto, Shunsuke, Ochiai, Hiroki, Kanemitsu, Yukihide
Médium: Journal Article
Jazyk:angličtina
Vydáno: Cham Springer International Publishing 01.01.2018
Témata:
Adult
Aged
Aged, 80 and over
Antineoplastic Combined Chemotherapy Protocols - therapeutic use
Chemotherapy, Adjuvant
Colorectal Cancer
Colorectal Neoplasms - drug therapy
Colorectal Neoplasms - pathology
Colorectal Neoplasms - surgery
Cytoreduction Surgical Procedures
Female
Fluorouracil - administration & dosage
Humans
Hyperthermia, Induced
Lymph Node Excision
Male
Medicine
Medicine & Public Health
Metastasectomy
Middle Aged
Neoplasm, Residual
Oncology
Oxaliplatin - administration & dosage
Peritoneal Neoplasms - drug therapy
Peritoneal Neoplasms - pathology
Peritoneal Neoplasms - secondary
Peritoneal Neoplasms - surgery
Prognosis
Retrospective Studies
Surgery
Surgical Oncology
Survival Rate
Time Factors
Tumor Burden
NCCN guidelines
Peritoneal metastasis
R0 resection
Colorectal cancer
ISSN:1068-9265, 1534-4681, 1534-4681
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Shrnutí:Background The National Comprehensive Cancer Network (NCCN) guidelines for colon cancer recently added the following footnote regarding the therapeutic strategy for peritoneal metastases: “If R0 resection can be achieved, surgical resection of isolated peritoneal disease may be considered at experienced centers.” This study investigated the efficacy of R0 resection of peritoneal metastasis from colorectal cancer without cytoreductive surgery or hyperthermic intraperitoneal chemotherapy (HIPEC). Methods This retrospective cohort study was conducted at a single-institution tertiary care cancer center. Among 496 consecutive M1c colorectal cancer patients, R0 resection was achieved for 94 patients (19%). The subjects were 78 consecutive patients with colorectal cancer and simultaneous peritoneal metastasis but no other distant metastases who underwent R0 resection at the National Cancer Center Hospital from 1971 to 2016 (16% of all M1c patients). Overall survival (OS) was investigated, and clinicopathologic variables were analyzed for prognostic significance. Results No perioperative mortality was noted. The 3-year OS rate was 45%, and the 5-year OS rate was 28.7%. The median survival time was 33.4 months. Notably, 17 patients survived for more than 5 years, and 9 of these patients did not receive any chemotherapy. Multivariate analysis showed cancer location in the colon and harvesting of 12 or more lymph nodes to be independent factors associated with a better prognosis. Conclusions From the perspective of long-term outcomes and no perioperative mortality, R0 resection of peritoneal metastasis from colorectal cancer, without complete peritonectomy or HIPEC, appeared to be an acceptable therapeutic option for some patients with peritoneal metastasis.
Bibliografie:ObjectType-Article-1
SourceType-Scholarly Journals-1
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ISSN:1068-9265
1534-4681
1534-4681
DOI:10.1245/s10434-017-6133-7