Synchronous and Metachronous Peritoneal Metastases in Patients with Left-Sided Obstructive Colon Cancer
DUTCH SNAPSHOT RESEARCH GROUP
(2020) Annals of Surgical Oncology, volume 27, issue 8, pp. 2762 - 2773
(Article)
Abstract
Background: Controversy exists on emergency setting as a risk factor for peritoneal metastases (PM) in colon cancer patients. Data in patients with obstruction are scarce. The aim of this study was to determine the incidence of synchronous and metachronous PM, risk factors for the development of metachronous PM, and prognostic
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implications within a large nationwide cohort of left-sided obstructive colon cancer (LSOCC). Methods: Patients with LSOCC treated between 2009 and 2016 were selected from the Dutch ColoRectal Audit. Additional treatment and long-term outcome data were retrospectively collected from original patient files in 75 hospitals in 2017. Results: In total, 3038 patients with confirmed obstruction and without perforation were included. Synchronous PM (at diagnosis or < 30 days postoperatively) were diagnosed in 148/2976 evaluable patients (5.0%), and 3-year cumulative metachronous PM rate was 9.9%. Multivariable Cox regression analyses revealed pT4 stage (HR 1.782, 95% CI 1.191–2.668) and pN2 stage (HR 2.101, 95% CI 1.208–3.653) of the primary tumor to be independent risk factors for the development of metachronous PM. Median overall survival in patients with or without synchronous PM was 20 and 63 months (p < 0.001) and 3-year overall survival of patients that did or did not develop metachronous PM was 48.1% and 77.0%, respectively (p < 0.001). Conclusion: This population based study revealed a 5.0% incidence of synchronous peritoneal metastases in patients who underwent resection of left-sided obstructive colon cancer. The subsequent 3-year cumulative metachronous PM rate was 9.9%, with advanced tumor and nodal stage as independent risk factors for the development of PM.
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Keywords: Surgery, Oncology
ISSN: 1068-9265
Publisher: Springer New York
Note: Funding Information: Grant from the Dutch Cancer Society (KWF) and Citrienfonds. Acknowledgements Funding Information: Dutch Snapshot Research Group Collaborators: H Algera, G D Algie, CS Andeweg, TE Argillander, MNNJ Arron, K Arts, THJ Aufenacker, IS Bakker, M van Basten Batenburg, AJNM Bastiaansen, G L Beets, A van den Berg, B van de Beukel, RLGM Blom, B Blomberg, EG Boerma, FC den Boer, WAA Borstlap, ND Bouvy, JE Bouwman, NDA Boye, ARM Brandt-Kerkhof, HT Bransma, A Breijer, WT van den Broek, MEE Br?ker, JPM Burbach, ERJ Bruns, TA Burghgraef, RMPH Crolla, M Dam, L Daniels, JWT Dekker, A Demirkiran, KW van Dongen, SF Durmaz, A van Esch, JA van Essen, P Fockens, JW Foppen, EJB Furnee, AAW van Geloven, MF Gerhards, EA Gorter, WMU van Grevenstein, J van Groningen, IAJ de Groot-van Veen, HE Haak, JWA de Haas, P van Hagen, EE van Halsema, JTH Hamminga, K Havenga, B van den Hengel, E van der Harst, J Heemskerk, J Heeren, BHM Heijnen, L Heijnen, JT Heikens, M van Heinsbergen, DA Hess, N Heuchemer, C Hoff, W Hogendoorn, APJ Houdijk, N Hugen, B Inberg, TL Janssen, D Jean Pierre, WJ de Jong, ACHM Jongen, AV Kamman, JM Klaase, W Kelder, EF Kelling, R Klicks, GW De Klein, FWH Kloppenberg, JLM Konsten, LJER Koolen, V Kornmann, RTJ Kortekaas, A Kreiter, B Lamme, JF Lange, T Lettinga, D Lips, G Lo, F Logeman, YT van Loon, MF Lutke Holzik, CCM Marres, I Masselink, A Mearadji, G Meisen, AG Menon, JWS Merkus, DJLM de Mey, HCJ van der Mijle, DE Moes, CJL Molenaar, M J Nieboer, K Nielsen, GAP Nieuwenhuijzen, PA Neijenhuis, P Oomen, N van Oorschot, K Parry, KCMJ Peeters, T Paulides, I Paulusma, FB Poelmann, SW Polle, P Poortman, MH Raber, RJ Renger, BMM Reiber, R Roukema, WMJ de Ruijter, MJAM Russchen, HJT Rutten, J Scheerhoorn, S Scheurs, H Schippers, VNE Schuermans, HJ Schuijt, PD Siersema, JC Sierink, C Sietses, R Silvis, J van der Slegt, GD Slooter, M van der Sluis, P van der Sluis, N Smakman, D Smit, AB Smits, TC van Sprundel, DJA Sonneveld, C Steur, J Straatman, MC Struijs, HA Swank, AK Talsma, M Tenhagen, F ter Borg, JAMG Tol, JL Tolenaar, L Tseng, JB Tuynman, MJF van Veen, SC Veltkamp, AWH van de Ven, L Verkoele, M Vermaas, HP Versteegh, L Verslijs, T Visser, D van Uden, WJ Vles, RJ de Vos tot Nederveen Cappel, HS de Vries, ST van Vugt, G Vugts, JA Wegdam, TJ Weijs, BJ van Wely, M Westerterp, HL van Westreenen, B Wiering, NAT Wijffels, AA Wijkmans, LH Wijngaarden, M van de Wilt, F Wit, ES van der Zaag, DDE Zimmerman, TLR Zwols. Funding Information: We have no competing interests for this specific study. All outside of the submitted work, J.E. van Hooft received a grant from Cook Medicals and a consultancy fee from Boston Scientific and Medtronics. P.D. Siersema receives grant support from Pentax Medical, Norgine, EndoStim and Motus GI, and is on the advisory board of Pentax, Ella-CS and Boston Scientific. I.H.J.T. de Hingh has received unrestricted research funding from QPS/RanD, ROCHE, and the Dutch Cancer Society. Publisher Copyright: © 2020, The Author(s).
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