Incidence and Prognostic Value of Positive Peritoneal Cytology in Colorectal Cancer

Kanellos, Ioannis; Demetriades, H.; Zintzaras, Elias; Mandrali, A.; Mantzoros, Ioannis; Betsis, D.

doi:10.1007/s10350-004-6595-0

Cited by 85 publications

(69 citation statements)

References 16 publications

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“…According to Kanellos et al (2006c), the measurement of the CEA level in the blood intraoperatively taken from the mesenteric vein offers some advantage, as both indicator of hepatic metastases and predictor of 5-year survival. The same investigators also found a higher recurrence rate in patients with both high CEA levels and positive citology in peritoneal washings taken at the beginning of surgery (Kanellos et al, 2003(Kanellos et al, , 2006b. Several patients in the present series were referred to our unit from a neighbouring hospital with preoperative CEA often not technically comparable or even not assessed.…”

Section: Discussionsupporting

confidence: 64%

New insights into the role of age and carcinoembryonic antigen in the prognosis of colorectal cancer

et al. 2007

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The aim of this study was to verify through relative survival (an estimate of cancer-specific survival) the true prognostic factors of colorectal cancer. The study involved 506 patients who underwent locally radical resection. All the clinical, histological and laboratory parameters were prognostically analysed for both overall and relative survival. This latter was calculated from the expected survival of the general population with identical age, sex and calendar years of observation. Univariate and multivariate analyses were applied to the proportional hazards model. Liver metastases, age, lymph node involvement and depth of bowel wall involvement were independent prognosticators of both overall and relative survival, whereas carcinoembryonic antigen (CEA) was predictive only of relative survival. Increasing age was unfavourably related to overall survival, but mildly protective with regard to relative survival. Three out of the five prognostic factors identified are the cornerstones of the current staging systems, and were confirmed as adequate by the analysis of relative survival. The results regarding age explain the conflicting findings so far obtained from studies considering overall survival only and advise against the adoption of absolute age limits in therapeutic protocols. Moreover, the prechemotherapy CEA level showed a high clinical value. British Journal of Cancer (2008) A large body of investigational data demonstrates that the prognosis of patients undergoing bowel resection for colorectal cancer is mainly determined by factors related to local tumour growth and the presence or absence of nodal and/or distant metastases. Many classification systems have been devised to categorise these anatomical factors for clinical use but an increasing number of new pathological and nonanatomical elements show interesting correlations with survival and would be worth testing systematically for selective integration into the available staging classifications. Improvement of the prognostic accuracy of these classifications might allow a more flexible use of the increasing number of new drugs and therapeutic options now available for postsurgical management of patients with colorectal cancer. However, since this malignancy is a disease of the elderly and the populations of developed countries are ageing rapidly, overall survival, as currently investigated, may not be the most suitable outcome parameter for evaluating the real prognostic impact of tumour-linked factors. Because about one-half of all colorectal carcinomas in our series occur in people aged 65 years or older, and a considerable number of these subjects die of other causes with no evidence of cancer, a fraction of these deaths should not be related to the tumour.There are two main purposes of the present work: (1) to verify the prognostic significance of the current clinicopathological factors through a study of both overall and relative survival, this latter being a selective estimate of the chance of surviving the effects of cancer; (2) to includ...

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Section: Discussionsupporting

confidence: 64%

New insights into the role of age and carcinoembryonic antigen in the prognosis of colorectal cancer

et al. 2007

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“…It is unclear how the tumor cells were implanted to abdominal wall in our case but we think that it was due to tumor cells seeding during first operation. In the literature it has been shown that despite the fact that there is often a relatively long interval between time of primary surgery and time of initial metastasis (2-49 months), prognosis with such abdominal wall metastatic disease is poor (14). In our study, the interval between time of primary surgery and abdominal wall metastatic disease was 24 months and metastasis detection time was compatible with literature.…”

Section: Discussionsupporting

confidence: 90%

“…These are eligible sites for metastasis of the tumor cells (13). Evidence from clinical and experimental studies suggests that surgical trauma may promote tumor metastasis to the abdominal wall (14). The importance of exfoliated cancer cells has been studied by several authors (15).…”

Section: Discussionmentioning

confidence: 99%

“…It is thought that cancer cells may be present in the peritoneal cavity before the surgical procedure or may be exfoliated during operative manipulation (12). Trauma to a tissue has been known to enhance the growth of tumor cells either implanted into the peritoneal cavity or delivery to the tissues via the circulation (14). The more evidence of promoting tumor cells in the healing tissues of the laparotomy incision or the anastomosis were explained with hematogenous implantation (15).…”

Section: Discussionmentioning

confidence: 99%

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A Case of Parastomal Hernia with Isolated Abdominal Wall Metastasis of Colorectal Cancer

Özyıldız¹,

Yazıcıoğlu²,

Turgut³

et al. 2017

Acta Oncol Tur.

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ÖZETKolorektal kanserin en yaygın uzak ve lokal metastazı sırasıyla karaciğer ve küçük pelvise olur. Kolorektal kanserin atipik lokalizasyonda izole metastazı, tanı anında ya da ameliyat sonrası izlem sürecinde görülebilir. Cerrahi teknik, kanserin evresi ve hastalığın doğal seyri gibi birden fazla faktör bu sürecin hayati bileşenlerini oluştursa bile bunların çoğunluğu tümör kolonizasyonu nedeniyle oluşur. Ancak tümör dökülmesine bağlı lokal nüksle nadiren karşılaşılır ve cerrahi teknik eksikliği en çok suçlanan nedendir. 72 yaşındaki kadın hastada da tübülövillöz adenoma zemininde gelişen orta derecede diferansiye distal rektal adenokarsinom (T1N0M0) için 2012 yılında geçirdiği APR (Abdominoperineal rezeksiyon) ameliyatından iki yıl sonra Parastomal herni tespit edildi. Parastomal herni onarımı için operasyona alınan hastada karın duvarının içinde şüpheli bir kitle palpe edildi. Kitle eksize edildi ve patolojik inceleme sonrası adenokarsinom olarak rapor edildi. Yeniden operasyona alınan hastaya kolostomi ile çevresindeki cildin ve 15 cm kolon segmentinin rezeksiyonunu içeren geniş rezeksiyon yapıldı. Biz, kolorektal kanserin izole metastazının izlem süresi boyunca görülebileceğini, bu nedenle atipik lokalizasyondaki herhangi bir kitlenin dikkatli değerlendirilmesi gerektiğini vurgulamayı amaçladık. Anahtar kelimeler: kolorektal kanser, parastomal herni, adenokanser, izole batın duvarı metastazı, kolostomi ABSTRACTThe most common distant and local metastasis of colorectal cancer is to liver and small pelvis respectively. The isolated metastasis of colorectal cancer in the atypical localization can be seen at the time of diagnosis or at postoperative follow-up period. Multiple factors such as surgical technique, stage of cancer, and natural history of the disease are vital components of the process, however majority of them are due to tumor colonization. However local recurrence due to tumor exfoliation rarely encountered, indetermination of surgical technique is the most accused reason. Parastomal hernia was detected in a 72 years old female patient two years after her APR (Abdominoperineal resection) operation in 2012 for moderately differentiated distal rectal adenocarcinoma (T1N0M0) that developed over tubulovillous adenoma. We found a suspicious mass within the abdominal wall closed to parastomal hernia in the operation. The mass was excised and reported as adenocarcinoma after pathological examination. Reoperation was planned and wide resection was performed with appropriate surgical margin including 15 cm of colon loops with skin of colostomy site. We aimed to emphasize that isolated metastasis of colorectal cancer can be seen during follow-up period so that any mass at atypical localization must be evaluated carefully.

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“…The degree of surgical trauma to mesothelial surfaces correlates directly with the rate of tumor recurrence (10,11). Further, exfoliated cancer cells during resection of primary tumors correlated with intra-peritoneal tumor recurrence (12)(13)(14). Surgery induces a sterile inflammatory response, which results in up-regulation of adhesion molecules such as intercellular cell adhesion molecule…”

Section: Introductionmentioning

confidence: 99%

Simvastatin reduces tumor cell adhesion to human peritoneal mesothelial cells by decreased expression of VCAM-1 and β1 integrin

et al. 2011

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Abstract. Peritoneal carcinomatosis describes cancer metastasis onto the surface of the peritoneum. It is frequently caused by ovarian and colorectal cancer. Once a tumor has penetrated the peritoneum, cancer cells disseminate into the abdominal cavity. Additionally, surgery can account for the spread of free tumor cells. Their subsequent adhesion to mesothelial cells (HMCs) initiates peritoneal carcinomatosis. Therefore, this study analyzed the effect of simvastatin on tumor cell adherence. HMCs were isolated from human greater omentum. Fluorescence-labeled tumor cells (SKOV-3, OvCar-29, OAW42, FraWü; ovarian/HT29; colorectal) were incubated on confluent mesothelial monolayers with 10 µM simvastatin for 48 h. Adhesion was quantified using a fluorescence reader. Expression of the adhesion molecules VCAM-1, ICAM-1 and β 1 integrin chain under the influence of simvastatin 0.1-100 µM for 24-72 h was analyzed using flow cytometry. Simvastatin significantly reduced the adhesion of all ovarian cancer cells and HT29 to HMCs (P≤0.001). Concomitantly simvastatin decreased the expression of VCAM-1 on HMCs. ICAM-1 and β 1 integrin chain expression on ovarian cancer cells was also clearly reduced. By contrast, the expression of the analyzed adhesion molecules on HT29 cells remained unchanged. Simvastatin clearly inhibits tumor cell adhesion to HMCs. In the case of ovarian cancer cell lines it appears to be mediated by decreased expression of both VCAM-1 on HMCs and the integrin α 4 β 1 on tumor cells. As an example of adhesion molecule down-regulating drugs, simvastatin may provide a novel therapeutic approach to the prevention of peritoneal carcinomatosis.

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Incidence and Prognostic Value of Positive Peritoneal Cytology in Colorectal Cancer

Abstract: Cytologic examination of peritoneal lavage at the time of surgery could be a useful prognostic indicator for local and peritoneal recurrence rate. However, it was not found to be a predictor of survival.

Cited by 85 publications

References 16 publications

New insights into the role of age and carcinoembryonic antigen in the prognosis of colorectal cancer

New insights into the role of age and carcinoembryonic antigen in the prognosis of colorectal cancer

A Case of Parastomal Hernia with Isolated Abdominal Wall Metastasis of Colorectal Cancer

Simvastatin reduces tumor cell adhesion to human peritoneal mesothelial cells by decreased expression of VCAM-1 and β1 integrin

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