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Does Primary Tumor Side Matter in Patients with Metastatic Colon Cancer Treated with Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy?

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

Abstract

Background

Primary tumor location has been shown to be prognostic of overall survival (OS) in patients with both locally advanced and metastatic colorectal cancer. The impact of sidedness on prognosis has not been evaluated in the setting of peritoneal-only metastases treated with cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC).

Methods

A retrospective review of prospectively maintained databases of patients with peritoneal surface malignancy undergoing CRS/HIPEC from three high-volume centers was performed.

Results

A total of 115 patients with metastatic colon cancer to the peritoneum who underwent CRS/HIPEC with mitomycin C were identified. Fifty-one patients (45%) had left-sided primary tumors, and 64 (55%) had right-sided primary tumors. Patients with right-sided tumors were more likely to be older (median age 56 vs. 49 years, p = 0.007) and to have signet ring cell histology (17% vs. 4%, p = 0.026). Patients with right-sided tumors had median disease-free survival (DFS) and OS of 14 months (95% confidence interval [CI] 10.5–17.5) and 36 months (95% CI 27.4–44.6), respectively, versus 16 months (95% CI 11.0–21.0) and 69 months (95% CI 24.3–113.7) for those patients with left-sided tumors. On multivariate analysis, primary tumor side was an independent predictor of both DFS and OS.

Conclusions

In this study, there was a dramatic, clinically significant difference in OS between patients with right- and left-sided tumors, and primary tumor side was an independent predictor of DFS and OS. Primary tumor side should be considered in patient selection for CRS with or without HIPEC.

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Acknowledgment

The authors would like to acknowledge and thank Shirley Tejidor, our Regional Therapies Program Manager, for her outstanding work.

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Authors and Affiliations

  1. Department of Surgery, Division of Surgical Oncology, Moores Cancer Center, University of California, San Diego, La Jolla, CA, USA

    Kaitlyn J. Kelly MD, Masumah Alsayadnasser MD, Jula Veerapong MD, Joel M. Baumgartner MD, MAS & Andrew M. Lowy MD

  2. Department of Family Medicine and Public Health, Division of Biostatistics and Bioinformatics, University of California, San Diego, San Diego, CA, USA

    Florin Vaida PhD

  3. Department of Surgery, Division of Surgical Oncology, University of Cincinnati, Cincinnati, OH, USA

    Sameer Patel MD & Syed Ahmad MD

  4. Department of Surgery, Sharp Memorial Hospital, San Diego, CA, USA

    Robert Barone MD

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  1. Kaitlyn J. Kelly MD
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  2. Masumah Alsayadnasser MD
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  3. Florin Vaida PhD
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  4. Jula Veerapong MD
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  5. Joel M. Baumgartner MD, MAS
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  6. Sameer Patel MD
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  7. Syed Ahmad MD
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  8. Robert Barone MD
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  9. Andrew M. Lowy MD
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Correspondence to Kaitlyn J. Kelly MD.

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Kelly, K.J., Alsayadnasser, M., Vaida, F. et al. Does Primary Tumor Side Matter in Patients with Metastatic Colon Cancer Treated with Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy?. Ann Surg Oncol 26, 1421–1427 (2019). https://doi.org/10.1245/s10434-019-07255-5

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  • DOI: https://doi.org/10.1245/s10434-019-07255-5

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