Revised prognostic indicators for treatment of lymph node positive colorectal peritoneal metastases.
Revised prognostic indicators for treatment of lymph node positive colorectal peritoneal metastases.
- 2022
BACKGROUND: Peritoneal metastases from colon and rectal cancer presents a new target for a regional approach to treatment. Proper patient selection requires an understanding of the natural history of the disease progression. CONCLUSIONS: Reduced survival occurred with a right-sided or rectal primary cancer, a CEA >10, tumor cell entrapment, and involvement of abdominopelvic regions 6 and 11. Effective NAC showed a favorable outcome. Copyright © 2022 Wiley Periodicals LLC. METHODS: Data from colorectal cancer patients treated for peritoneal metastases by cytoreductive surgery (CRS) plus hyperthermic intraperitoneal chemotherapy and early postoperative intraperitoneal chemotherapy and the records from the primary colon or rectal cancer surgery were analyzed to assess their impact on survival. Data regarding the anatomic sites of colorectal peritoneal metastases was gathered at the time of a complete CRS. RESULTS: A cohort of 73 patients with peritoneal metastases and lymph node metastases but no liver metastases provided the information. All patients had a complete cytoreduction. Left-sided primary cancer and a complete or near complete response to neoadjuvant chemotherapy (NAC) indicated improved survival. Tumor progression within the abdominal incision, carcinoembryonic antigen (CEA) >10, peritoneal cancer index >9 and peritoneal metastases present in the abdominopelvic regions 6 and 11 carried an especially guarded prognosis.
English
0022-4790
10.1002/jso.26792 [doi]
*Colorectal Neoplasms
*Hyperthermia, Induced
*Peritoneal Neoplasms
Antineoplastic Combined Chemotherapy Protocols/tu [Therapeutic Use]
Colorectal Neoplasms/pa [Pathology]
Combined Modality Therapy
Cytoreduction Surgical Procedures
Humans
Lymph Nodes/pa [Pathology]
Lymphatic Metastasis
Peritoneal Neoplasms/sc [Secondary]
Prognosis
Survival Rate
Washington Cancer Institute
Journal Article
BACKGROUND: Peritoneal metastases from colon and rectal cancer presents a new target for a regional approach to treatment. Proper patient selection requires an understanding of the natural history of the disease progression. CONCLUSIONS: Reduced survival occurred with a right-sided or rectal primary cancer, a CEA >10, tumor cell entrapment, and involvement of abdominopelvic regions 6 and 11. Effective NAC showed a favorable outcome. Copyright © 2022 Wiley Periodicals LLC. METHODS: Data from colorectal cancer patients treated for peritoneal metastases by cytoreductive surgery (CRS) plus hyperthermic intraperitoneal chemotherapy and early postoperative intraperitoneal chemotherapy and the records from the primary colon or rectal cancer surgery were analyzed to assess their impact on survival. Data regarding the anatomic sites of colorectal peritoneal metastases was gathered at the time of a complete CRS. RESULTS: A cohort of 73 patients with peritoneal metastases and lymph node metastases but no liver metastases provided the information. All patients had a complete cytoreduction. Left-sided primary cancer and a complete or near complete response to neoadjuvant chemotherapy (NAC) indicated improved survival. Tumor progression within the abdominal incision, carcinoembryonic antigen (CEA) >10, peritoneal cancer index >9 and peritoneal metastases present in the abdominopelvic regions 6 and 11 carried an especially guarded prognosis.
English
0022-4790
10.1002/jso.26792 [doi]
*Colorectal Neoplasms
*Hyperthermia, Induced
*Peritoneal Neoplasms
Antineoplastic Combined Chemotherapy Protocols/tu [Therapeutic Use]
Colorectal Neoplasms/pa [Pathology]
Combined Modality Therapy
Cytoreduction Surgical Procedures
Humans
Lymph Nodes/pa [Pathology]
Lymphatic Metastasis
Peritoneal Neoplasms/sc [Secondary]
Prognosis
Survival Rate
Washington Cancer Institute
Journal Article