Clinical and Histopathologic Features of 35 Patients Treated for Colorectal Peritoneal Metastases Who Survived 5 Years.

MedStar author(s):
Citation: Diseases of the Colon & Rectum. 2023 Feb 28PMID: 36856661Institution: MedStar Health Research Institute | Washington Cancer InstituteDepartment: MedStar General Surgery Residency | MedStar Georgetown University Hospital/MedStar Washington Hospital CenterForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: IN PROCESS -- NOT YET INDEXEDYear: 2023Local holdings: Available online from MWHC library: 1997 - present, Available in print through MWHC library: 1999 - 2006ISSN:
  • 0012-3706
Name of journal: Diseases of the colon and rectumAbstract: BACKGROUND: Currently, patients with a limited extent of peritoneal metastases from colon and rectal cancer are treated by cytoreductive surgery combined with perioperative chemotherapy performed at experienced centers.CONCLUSIONS: The tumor biology as revealed by lymph node status and tumor differentiation plus extent of disease as measured by the response to neoadjuvant chemotherapy, peritoneal cancer index and no visible residual disease indicated a favorable outcome. See Video Abstract at http://links.lww.com/DCR/C62. Copyright © The ASCRS 2023.DESIGN: This is a retrospective review of a prospective database.LIMITATIONS: The study was limited by the retrospective nature, by unmeasured confounders, and data from a single institution.MAIN OUTCOME MEASURES: The primary outcomes measured were the clinical-, histologic- and treatment-related features that had an impact on 5-year survival.OBJECTIVE: To study and statistically evaluate features that may impact on survival of 5 years or more. These data are used in the risk/benefit analyses performed by the multidisciplinary team.PATIENTS: All patients who had biopsy-proven colon or rectal peritoneal metastases treated by systemic chemotherapy, complete cytoreductive surgery and perioperative surgery.RESULTS: From 131 patients who had a complete cytoreduction, 35 patients (26.7%) were identified as 5-year survivors. Median survival was 27 months. There were 16 males. Median age was 50.5 with a range of 25 to 80. By univariant analysis, an absence of lymph node involvement at the time of primary colorectal cancer resection (HR 1.899 (1.064, 3.388) p = 0.03), complete or near complete response to neoadjuvant chemotherapy (HR 0.251 (0.092, 0.684) p = 0.007), peritoneal cancer index <=17 (HR 0.509 (0.329, 0.788) p = 0.002), complete visible resection of disease indicated by completeness of cytoreduction score of 0 (HR 0.412 (0.224, 0.756) p = 0.004) and well-differentiated tumor (HR 0.34 (0.157, 0.737) p = 0.006) were significantly associated with 5 years or greater survival.SETTINGS: Single institution study at an academic center.All authors: Ghabra S, Desale S, Sugarbaker PHFiscal year: FY2023Digital Object Identifier: Date added to catalog: 2023-04-11
Holdings
Item type Current library Collection Call number Status Date due Barcode
Journal Article MedStar Authors Catalog Article Available

Available online from MWHC library: 1997 - present, Available in print through MWHC library: 1999 - 2006

BACKGROUND: Currently, patients with a limited extent of peritoneal metastases from colon and rectal cancer are treated by cytoreductive surgery combined with perioperative chemotherapy performed at experienced centers.

CONCLUSIONS: The tumor biology as revealed by lymph node status and tumor differentiation plus extent of disease as measured by the response to neoadjuvant chemotherapy, peritoneal cancer index and no visible residual disease indicated a favorable outcome. See Video Abstract at http://links.lww.com/DCR/C62. Copyright © The ASCRS 2023.

DESIGN: This is a retrospective review of a prospective database.

LIMITATIONS: The study was limited by the retrospective nature, by unmeasured confounders, and data from a single institution.

MAIN OUTCOME MEASURES: The primary outcomes measured were the clinical-, histologic- and treatment-related features that had an impact on 5-year survival.

OBJECTIVE: To study and statistically evaluate features that may impact on survival of 5 years or more. These data are used in the risk/benefit analyses performed by the multidisciplinary team.

PATIENTS: All patients who had biopsy-proven colon or rectal peritoneal metastases treated by systemic chemotherapy, complete cytoreductive surgery and perioperative surgery.

RESULTS: From 131 patients who had a complete cytoreduction, 35 patients (26.7%) were identified as 5-year survivors. Median survival was 27 months. There were 16 males. Median age was 50.5 with a range of 25 to 80. By univariant analysis, an absence of lymph node involvement at the time of primary colorectal cancer resection (HR 1.899 (1.064, 3.388) p = 0.03), complete or near complete response to neoadjuvant chemotherapy (HR 0.251 (0.092, 0.684) p = 0.007), peritoneal cancer index <=17 (HR 0.509 (0.329, 0.788) p = 0.002), complete visible resection of disease indicated by completeness of cytoreduction score of 0 (HR 0.412 (0.224, 0.756) p = 0.004) and well-differentiated tumor (HR 0.34 (0.157, 0.737) p = 0.006) were significantly associated with 5 years or greater survival.

SETTINGS: Single institution study at an academic center.

English

Powered by Koha