Clinical benefit of surgery for stage IV colorectal cancer with synchronous peritoneal metastasis View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2013-06-24

AUTHORS

Hirotoshi Kobayashi, Kenjiro Kotake, Kimihiko Funahashi, Kazuo Hase, Koichi Hirata, Tsuneo Iiai, Shingo Kameoka, Yukihide Kanemitsu, Koutarou Maeda, Akihiko Murata, Masayuki Ohue, Kazuo Shirouzu, Keiichi Takahashi, Toshiaki Watanabe, Hideaki Yano, Toshimasa Yatsuoka, Yojiro Hashiguchi, Kenichi Sugihara, Study Group for Peritoneal Metastasis from Colorectal Cancer by the Japanese Society for Cancer of the Colon and Rectum

ABSTRACT

BackgroundPeritoneal metastasis is well-known as a poor prognostic factor in patients with colorectal cancer. It is important to improve the prognosis of patients with colorectal cancer and synchronous peritoneal metastasis. This study aimed to clarify the factors affecting R0 resection and the prognosis of colorectal cancer patients with synchronous peritoneal metastasis.MethodsWe investigated the data of patients with stage IV colorectal cancer between 1991 and 2007 in 16 hospitals that were members of the Japanese Society for Cancer of the Colon and Rectum.ResultsOf the 564 colorectal cancer patients with synchronous peritoneal metastases, 341 also had hematogenous metastases. The 5-year overall survival rates in patients with and without R0 resection were 32.4 and 4.7 %, respectively. A Cox proportional hazards model showed that histologic type of poorly differentiated adenocarcinoma, regional lymph node metastasis, liver metastasis, chemotherapy after surgery, R0 resection, the Japanese classification of peritoneal metastasis, and the size of peritoneal metastases were independent prognostic factors. Of the 564 patients, 28.4 % had R0 resection. The Japanese classification of peritoneal metastasis (P1–P2, p = 0.0024) and absence of hematogenous metastases (p < 0.0001) were associated with R0 resection.ConclusionsP1–P2 peritoneal metastasis and the absence of hematogenous metastasis were the most favorable factors benefiting from synchronous resection of peritoneal metastasis. In addition, chemotherapy after surgery was essential. More... »

PAGES

646-654

Journal

TITLE

Journal of Gastroenterology

ISSUE

4

VOLUME

49

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00535-013-0820-3

DOI

http://dx.doi.org/10.1007/s00535-013-0820-3

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1038217109

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/23793379


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374 grid-institutes:grid.265073.5 schema:alternateName Department of Surgical Oncology, Tokyo Medical and Dental University, Tokyo, Japan
375 schema:name Center for Minimally Invasive Surgery, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, 113-8519, Tokyo, Japan
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384 grid-institutes:grid.410800.d schema:alternateName Department of Surgery, Aichi Cancer Center, Nagoya, Japan
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394 schema:name Department of Surgery, National Defense Medical College, Tokorozawa, Japan
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397 schema:name Department of Surgery, Saitama Cancer Center, Saitama, Japan
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399 grid-institutes:grid.416963.f schema:alternateName Department of Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan
400 schema:name Department of Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan
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402 grid-institutes:grid.420115.3 schema:alternateName Department of Surgery, Tochigi Cancer Center, Utsunomiya, Japan
403 schema:name Department of Surgery, Tochigi Cancer Center, Utsunomiya, Japan
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405 grid-institutes:grid.45203.30 schema:alternateName Department of Surgery, National Center for Global Health and Medicine, Tokyo, Japan
406 schema:name Department of Surgery, National Center for Global Health and Medicine, Tokyo, Japan
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