TY - JOUR
T1 - Synchronous and Metachronous Peritoneal Metastases in Patients with Left-Sided Obstructive Colon Cancer
AU - Veld, Joyce Valerie
AU - Wisselink, Daniel Derk
AU - Amelung, Femke Julie
AU - Consten, Esther Catharina Josephina
AU - de Wilt, Johannes Hendrik Willem
AU - de Hingh, Ignace
AU - Bemelman, Wilhelmus Adrianus
AU - van Hooft, Jeanin Elise
AU - Tanis, Pieter Job
AU - Dutch Snapshot Research Group
AU - Algera, H.
AU - Algie, G. D.
AU - Andeweg, C. S.
AU - Argillander, T. E.
AU - Arron, M. N. N. J.
AU - Arts, K.
AU - Aufenacker, T. H. J.
AU - Bakker, I. S.
AU - van Basten Batenburg, M.
AU - Bastiaansen, A. J. N. M.
AU - Beets, G. L.
AU - van den Berg, A.
AU - van de Beukel, B.
AU - Blom, R. L. G. M.
AU - Blomberg, B.
AU - Boerma, E. G.
AU - den Boer, F. C.
AU - Borstlap, W. A. A.
AU - Bouvy, N. D.
AU - Bouwman, J. E.
AU - Boye, N. D. A.
AU - Brandt-Kerkhof, A. R. M.
AU - Bransma, H. T.
AU - Breijer, A.
AU - van den Broek, W. T.
AU - Bröker, M. E. E.
AU - Burbach, J. P. M.
AU - Bruns, E. R. J.
AU - Burghgraef, T. A.
AU - Crolla, R. M. P. H.
AU - Daniels, L.
AU - Fockens, P.
AU - van Halsema, E. E.
AU - Lamme, B.
AU - Marres, C. C. M.
AU - Polle, S. W.
AU - Sierink, J. C.
AU - Swank, H. A.
AU - Tuynman, J. B.
AU - van Westreenen, H. L.
AU - Wijffels, N. A. T.
N1 - Funding Information: Grant from the Dutch Cancer Society (KWF) and Citrienfonds. 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). Copyright: Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2020/8/1
Y1 - 2020/8/1
N2 - 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 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.
AB - 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 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.
UR - http://www.scopus.com/inward/record.url?scp=85082018744&partnerID=8YFLogxK
U2 - https://doi.org/10.1245/s10434-020-08327-7
DO - https://doi.org/10.1245/s10434-020-08327-7
M3 - Article
C2 - 32170481
SN - 1068-9265
VL - 27
SP - 2762
EP - 2773
JO - Annals of surgical oncology
JF - Annals of surgical oncology
IS - 8
ER -