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Peritoneal Carcinomatosis in T4 Colorectal Cancer: Occurrence and Risk Factors

  • Gastrointestinal Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Cytoreductive surgery with hyperthermic intraperitoneal chemotherapy improves outcome of patients with peritoneal carcinomatosis (PC) of colorectal carcinoma. Data on the occurrence of PC in T4 colorectal carcinoma are scarce. We investigated the occurrence and risk factors for PC in these patients.

Methods

This was a retrospective cohort study of patients undergoing a first resection of a T4 colorectal carcinoma in a tertiary hospital between January 2000 and December 2007. Primary outcome was the occurrence of synchronous or metachronous PC. The association with PC and several patient and tumor characteristics was evaluated using logistic regression.

Results

A total of 200 patients underwent resection of a T4 colorectal carcinoma. Median follow-up censored for death was 66 months (18–89 months). Synchronous PC was found in 46 of 200 patients (23 %) and metachronous PC in 33 of 154 patients (21 %). In univariable analysis, factors associated with PC were: age (OR 0.97; 95 % CI 0.94–0.99; P = 0.03), radical resection (OR 0.32; 95 % CI 0.11–0.91; P = 0.03), and N stage (OR 1.63; 95 % CI 1.36–2.34; P = 0.008). In multivariable analysis, only N stage was associated with PC (OR 1.62; 95 % CI 1.12–2.34; P = 0.01). This association was not significant for the 154 patients at risk for metachronous PC.

Conclusions

Around 1 in 5 patients undergoing resection of a T4 colorectal carcinoma either have PC during primary resection or develop PC during follow-up. N stage was associated with PC in the entire study population. However, none of the clinical or pathological variables were associated with the risk of metachronous PC and therefore cannot be used to develop targeted surveillance strategies.

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Authors and Affiliations

  1. Department of Surgery, St. Antonius Hospital, Nieuwegein, The Netherlands

    H. C. van Santvoort MD, PhD, H. J. Braam MD, K. R. Spekreijse MD, N. R. Koning MD, T. S. de Vries Reilingh MD, PhD, D. Boerma MD, PhD, A. B. Smits MD, PhD, M. J. Wiezer MD, PhD & B. van Ramshorst MD, PhD

  2. Department of Pathology, St. Antonius Hospital, Nieuwegein, The Netherlands

    P. C. de Bruin MD, PhD

Authors
  1. H. C. van Santvoort MD, PhD
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  2. H. J. Braam MD
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  3. K. R. Spekreijse MD
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  4. N. R. Koning MD
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  5. P. C. de Bruin MD, PhD
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  6. T. S. de Vries Reilingh MD, PhD
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  7. D. Boerma MD, PhD
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  8. A. B. Smits MD, PhD
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  9. M. J. Wiezer MD, PhD
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  10. B. van Ramshorst MD, PhD
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Corresponding author

Correspondence to B. van Ramshorst MD, PhD.

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van Santvoort, H.C., Braam, H.J., Spekreijse, K.R. et al. Peritoneal Carcinomatosis in T4 Colorectal Cancer: Occurrence and Risk Factors. Ann Surg Oncol 21, 1686–1691 (2014). https://doi.org/10.1245/s10434-013-3461-0

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  • DOI: https://doi.org/10.1245/s10434-013-3461-0

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