Factors Affecting the Prognosis after Primary Tumor Resection for Patients with Metastatic Colorectal Cancer with Synchronous Peritoneal Metastasis: A Multi-center, Prospective, Observational Study
Objectives: To clarify the risk factors affecting prognosis after primary tumor resection (PTR) in patients with metastatic colorectal cancer with synchronous peritoneal metastasis (mCRC-SPM). Methods: Patients were enrolled prospectively in the JSCCR project “Grading of Peritoneal Seeding in Colore...
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The Japan Society of Coloproctology
2025-01-01
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| Series: | Journal of the Anus, Rectum and Colon |
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| Online Access: | https://www.jstage.jst.go.jp/article/jarc/9/1/9_2024-056/_pdf/-char/en |
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| author | Satoru Kagami Kimihiko Funahashi Hirotoshi Kobayashi Kenjiro Kotake Masayasu Kawasaki Yusuke Kinugasa Hideki Ueno Kotaro Maeda Takeshi Suto Michio Itabashi Heita Ozawa Fumikazu Koyama Shingo Noura Hideyuki Ishida Masayuki Ohue Tomomichi Kiyomatsu Soichiro Ishihara Keiji Koda Hideo Baba Kenji Kawada Yojiro Hashiguchi Takanori Goi Yuji Toiyama Naohiro Tomita Eiji Sunami Fumihiko Fujita Jun Watanabe Kenichi Hakamada Goro Nakayama Kenichi Sugihara Yoichi Ajioka |
| author_facet | Satoru Kagami Kimihiko Funahashi Hirotoshi Kobayashi Kenjiro Kotake Masayasu Kawasaki Yusuke Kinugasa Hideki Ueno Kotaro Maeda Takeshi Suto Michio Itabashi Heita Ozawa Fumikazu Koyama Shingo Noura Hideyuki Ishida Masayuki Ohue Tomomichi Kiyomatsu Soichiro Ishihara Keiji Koda Hideo Baba Kenji Kawada Yojiro Hashiguchi Takanori Goi Yuji Toiyama Naohiro Tomita Eiji Sunami Fumihiko Fujita Jun Watanabe Kenichi Hakamada Goro Nakayama Kenichi Sugihara Yoichi Ajioka |
| author_sort | Satoru Kagami |
| collection | DOAJ |
| description | Objectives: To clarify the risk factors affecting prognosis after primary tumor resection (PTR) in patients with metastatic colorectal cancer with synchronous peritoneal metastasis (mCRC-SPM).
Methods: Patients were enrolled prospectively in the JSCCR project “Grading of Peritoneal Seeding in Colorectal Cancer.” Factors that may influence overall survival―age, sex, location of the primary tumor, lymph node metastasis, presence of liver metastasis, degree of peritoneal metastasis, peritoneal cancer index (PCI), cancer cure, and postoperative chemotherapy―in the PTR group were examined using multivariate analysis.
Results: Of the 133 enrolled patients with mCRC-SPM, 112 patients underwent PTR. Among them, 26 (23.2%) had mCRC-SPM of grade P1, 47 (42.0%) of P2, and 39 (34.8%) of P3. The median PCI was 4 (range, 1-28); no surgery-related deaths occurred. Postoperative complications of Clavien-Dindo classification grade 2 were observed in 20 (17.9%) patients. R0 surgery became more difficult as the degree of dissemination increased, and the PTR group had a significantly better prognosis than the non-PTR group. In the multivariate analysis, age 75 years, rectal cancer, presence of liver metastasis, higher PCI, non-curative resection, and non-treatment with systemic chemotherapy were associated with poor prognosis in patients after PTR.
Conclusions: In patients with mCRC-SPM, postoperative complications are infrequent for P1 with localized peritoneal dissemination, and PTR may be considered as aggressive treatment. Factors including age 75 years, rectal cancer, presence of liver metastasis, increased PCI, non-curative resection, and non-treatment with systemic chemotherapy are associated with a reduced survival benefit from PTR. |
| format | Article |
| id | doaj-art-a2ab350b1fdd4bfa8ad8e2b56f43089d |
| institution | Kabale University |
| issn | 2432-3853 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | The Japan Society of Coloproctology |
| record_format | Article |
| series | Journal of the Anus, Rectum and Colon |
| spelling | doaj-art-a2ab350b1fdd4bfa8ad8e2b56f43089d2025-01-27T10:02:40ZengThe Japan Society of ColoproctologyJournal of the Anus, Rectum and Colon2432-38532025-01-019113414410.23922/jarc.2024-0562024-056Factors Affecting the Prognosis after Primary Tumor Resection for Patients with Metastatic Colorectal Cancer with Synchronous Peritoneal Metastasis: A Multi-center, Prospective, Observational StudySatoru Kagami0Kimihiko Funahashi1Hirotoshi Kobayashi2Kenjiro Kotake3Masayasu Kawasaki4Yusuke Kinugasa5Hideki Ueno6Kotaro Maeda7Takeshi Suto8Michio Itabashi9Heita Ozawa10Fumikazu Koyama11Shingo Noura12Hideyuki Ishida13Masayuki Ohue14Tomomichi Kiyomatsu15Soichiro Ishihara16Keiji Koda17Hideo Baba18Kenji Kawada19Yojiro Hashiguchi20Takanori Goi21Yuji Toiyama22Naohiro Tomita23Eiji Sunami24Fumihiko Fujita25Jun Watanabe26Kenichi Hakamada27Goro Nakayama28Kenichi Sugihara29Yoichi Ajioka30Department of General and Gastroenterological Surgery, Toho University Omori Medical CenterDepartment of General and Gastroenterological Surgery, Toho University Omori Medical CenterDepartment of Surgery, Tokyo Metropolitan Hiroo HospitalDepartment of Surgery, Sano City HospitalDepartment of Surgery, Bell Land General HospitalDepartment of Gastrointestinal Surgery, Institute of Science TokyoDepartment of Surgery, National Defense Medical CollegeInternational Medical Center, Fujita Health University HospitalDepartment of Gastroenterological Surgery, Yamagata Prefectural Central HospitalDepartment of Surgery, Institute of Gastroenterology, Tokyo Women's Medical UniversityDepartment of Surgery, Tochigi Cancer CenterDepartment of Surgery, Nara Medical UniversityDepartment of Surgery, Osaka Rosai HospitalDepartment of Digestive Tract and General Surgery, Saitama Medical Center, Saitama Medical UniversityDepartment of Gastroenterological Surgery, Osaka International Cancer InstituteDepartment of Colorectal Surgery, National Center for Global Health and MedicineDepartment of Surgical Oncology, The University of Tokyo HospitalDepartment of Surgery, Teikyo University Chiba Medical CenterDepartment of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto UniversityDepartment of Gastrointestinal Surgery, Graduate School of Medicine, Kyoto UniversityDepartment of Surgery, Teikyo University School of MedicineFirst Department of Surgery, University of FukuiDepartment of Gastrointestinal and Pediatric Surgery, Division of Reparative Medicine, Institute of Life Sciences, Mie University Graduate School of MedicineDivision of Lower Gastrointestinal Surgery, Department of Gastroenterological Surgery, Hyogo Medical UniversityDepartment of Surgery, Kyorin University School of MedicineDepartment of Surgery, Kurume University School of MedicineDepartment of Colorectal Surgery, Kansai Medical UniversityDepartment of Gastroenterological Surgery, Hirosaki University Graduate School of MedicineDepartment of Gastroenterological Surgery (Surgery II), Nagoya University Graduate School of MedicineInstitute of Science TokyoDivision of Molecular and Diagnostic Pathology, Niigata University, Graduate School of Medical and Dental SciencesObjectives: To clarify the risk factors affecting prognosis after primary tumor resection (PTR) in patients with metastatic colorectal cancer with synchronous peritoneal metastasis (mCRC-SPM). Methods: Patients were enrolled prospectively in the JSCCR project “Grading of Peritoneal Seeding in Colorectal Cancer.” Factors that may influence overall survival―age, sex, location of the primary tumor, lymph node metastasis, presence of liver metastasis, degree of peritoneal metastasis, peritoneal cancer index (PCI), cancer cure, and postoperative chemotherapy―in the PTR group were examined using multivariate analysis. Results: Of the 133 enrolled patients with mCRC-SPM, 112 patients underwent PTR. Among them, 26 (23.2%) had mCRC-SPM of grade P1, 47 (42.0%) of P2, and 39 (34.8%) of P3. The median PCI was 4 (range, 1-28); no surgery-related deaths occurred. Postoperative complications of Clavien-Dindo classification grade 2 were observed in 20 (17.9%) patients. R0 surgery became more difficult as the degree of dissemination increased, and the PTR group had a significantly better prognosis than the non-PTR group. In the multivariate analysis, age 75 years, rectal cancer, presence of liver metastasis, higher PCI, non-curative resection, and non-treatment with systemic chemotherapy were associated with poor prognosis in patients after PTR. Conclusions: In patients with mCRC-SPM, postoperative complications are infrequent for P1 with localized peritoneal dissemination, and PTR may be considered as aggressive treatment. Factors including age 75 years, rectal cancer, presence of liver metastasis, increased PCI, non-curative resection, and non-treatment with systemic chemotherapy are associated with a reduced survival benefit from PTR.https://www.jstage.jst.go.jp/article/jarc/9/1/9_2024-056/_pdf/-char/encolorectal cancerprimary tumor resectionprognosissynchronous peritoneal metastasis |
| spellingShingle | Satoru Kagami Kimihiko Funahashi Hirotoshi Kobayashi Kenjiro Kotake Masayasu Kawasaki Yusuke Kinugasa Hideki Ueno Kotaro Maeda Takeshi Suto Michio Itabashi Heita Ozawa Fumikazu Koyama Shingo Noura Hideyuki Ishida Masayuki Ohue Tomomichi Kiyomatsu Soichiro Ishihara Keiji Koda Hideo Baba Kenji Kawada Yojiro Hashiguchi Takanori Goi Yuji Toiyama Naohiro Tomita Eiji Sunami Fumihiko Fujita Jun Watanabe Kenichi Hakamada Goro Nakayama Kenichi Sugihara Yoichi Ajioka Factors Affecting the Prognosis after Primary Tumor Resection for Patients with Metastatic Colorectal Cancer with Synchronous Peritoneal Metastasis: A Multi-center, Prospective, Observational Study Journal of the Anus, Rectum and Colon colorectal cancer primary tumor resection prognosis synchronous peritoneal metastasis |
| title | Factors Affecting the Prognosis after Primary Tumor Resection for Patients with Metastatic Colorectal Cancer with Synchronous Peritoneal Metastasis: A Multi-center, Prospective, Observational Study |
| title_full | Factors Affecting the Prognosis after Primary Tumor Resection for Patients with Metastatic Colorectal Cancer with Synchronous Peritoneal Metastasis: A Multi-center, Prospective, Observational Study |
| title_fullStr | Factors Affecting the Prognosis after Primary Tumor Resection for Patients with Metastatic Colorectal Cancer with Synchronous Peritoneal Metastasis: A Multi-center, Prospective, Observational Study |
| title_full_unstemmed | Factors Affecting the Prognosis after Primary Tumor Resection for Patients with Metastatic Colorectal Cancer with Synchronous Peritoneal Metastasis: A Multi-center, Prospective, Observational Study |
| title_short | Factors Affecting the Prognosis after Primary Tumor Resection for Patients with Metastatic Colorectal Cancer with Synchronous Peritoneal Metastasis: A Multi-center, Prospective, Observational Study |
| title_sort | factors affecting the prognosis after primary tumor resection for patients with metastatic colorectal cancer with synchronous peritoneal metastasis a multi center prospective observational study |
| topic | colorectal cancer primary tumor resection prognosis synchronous peritoneal metastasis |
| url | https://www.jstage.jst.go.jp/article/jarc/9/1/9_2024-056/_pdf/-char/en |
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