Predictors and survival of synchronous peritoneal carcinomatosis of colorectal origin: A population‐based study

Abstract

The aim of our study was to provide population‐based data on incidence and prognosis of synchronous peritoneal carcinomatosis and to evaluate predictors for its development. Diagnosed in 1995–2008, 18,738 cases of primary colorectal cancer were included. Predictors of peritoneal carcinomatosis were analysed by multivariable logistic regression analysis. Median survival in months was calculated by site of metastasis. In the study period, 904 patients were diagnosed with synchronous peritoneal carcinomatosis (4.8% of total, constituting 24% of patients presenting with M1 disease). The risk of peritoneal carcinomatosis was increased in case of advanced T stage [T4 vs. T1,2: odds ratio (OR) 4.7, confidence limits 4.0–5.6), advanced N stage [N0 vs. N1,2: OR 0.2 (0.1–0.2)], poor differentiation grade [OR 2.1 (1.8–2.5)], younger age [<60 years vs. 70–79 years: OR 1.4 (1.1–1.7)], mucinous adenocarcinoma [OR 2.0 (1.6–2.4)] and right‐sided localisation of primary tumour [left vs. right: OR 0.6 (0.5–0.7)]. Median survival of patients with peritoneum as single site of metastasis remained dismal [1995–2001: 7 (6–9) months; 2002–2008: 8 (6–11) months], contrasting the improvement among patients with liver metastases [1995–2001: 8 (7–9) months; 2002–2008: 12 (11–14) months]. To conclude, synchronous peritoneal metastases from colorectal cancer are more frequent among younger patients and among patients with advanced T stage, mucinous adenocarcinoma, right‐sided tumours and tumours that are poorly differentiated. The prognosis of synchronous peritoneal carcinomatosis remains poor with a median survival of 8 months and even worse if concomitant metastases in other organs are present.

Multimodality treatment strategies have changed prognosis of peritoneal metastases

“…Despite the progressive development of systemic chemotherapy, in a populationbased study, Lemmens et al [9] confirmed the poor MS in PM patients (1995- …”

Carcinomatosis peritoneal secundaria a adenocarcinoma de células en anillo de sello del colon: A propósito de un caso

“…Suele darse en casos de cáncer de ovario, gástrico, colon y pancreático. Menos frecuentemente en el cáncer hepatocelular, renal, uterino, de vejiga, linfoma y los tumores de origen desconocido (4). Tiene como principal diagnóstico diferencial no tumoral a la tuberculosis (TBC) enteroperitoneal, con el cual es confundido frecuentemente por la presencia de los "granos de mijo" (5).…”

Update on Colorectal Carcinomatosis—From Molecular Biology to Diagnosis and Management

“…Peritoneal carcinomatosis (PC) consisted in the implantation of tumour cells throughout the peritoneal cavity [1] and, until recently, has been associated with a poor prognosis and considered a almost untreatable condition [1,2].…”

“…After liver metastases, PC is the second most frequent cause of death in patients with CRC [1,4] and it is present in 40% -80% of patients who die from CRC [4].…”

“…Occasionally, patients needed a surgical intervenetion for intestinal occlusion, haemorrhage, or perforation caused by CP but most realized laparotomies for taking biopsies and then being referred to their oncologists for treatment with systemic chemotherapy [2]. Nowadays, with the introduction of locoregional therapies, promising results are suggested by several centers, namely cytoreductive surgery (CRS) combined with intraoperative intraperitoneal chemotherapy (PIC) without/with hyperthermia [1,3].…”