Abstract
Purpose
Several guidelines have recommended surgical resection for localized peritoneal metastases, but the prognosis remains poor. In addition, the efficacy of adjuvant chemotherapy (AC) after curative resection is under debate. The present study compared long-term outcomes between curative and non-curative resection and evaluated the effects of AC after curative resection.
Methods
Using a multicenter database, we retrospectively reviewed 123 colorectal cancer patients with peritoneal metastases between April 2016 and December 2021. Of these patients, 49 underwent curative resection, and 74 underwent non-curative resection.
Results
The frequency of broad metastases was lower in the curative resection group (8.2%) than in the non-curative resection group (43.2%, p < 0.001). Among all patients, 5-year overall survival rate was higher in the curative resection group (43.0%) than in the non-curative resection group (7.3%, p = 0.004). Among patients who underwent curative resection, 5-year overall survival rate was significantly higher in the AC group (48.2%) than in the non-AC group (38.1%, p = 0.037). Multivariate analysis of all patients revealed pathological N status and non-curative resection as independent predictors of overall survival. In patients who underwent curative resection, advanced age was an independent predictor of relapse-free survival, and AC was an independent predictor of overall survival.
Conclusion
This multicenter study of colorectal cancer patients with peritoneal metastases revealed that prognosis was more favorable for curable cases than for non-curable cases. Prognosis was more favorable in the AC group than in the non-AC group after curative resection.
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Data availability
Raw data were generated at Nagasaki University Hospital. Derived data supporting the findings of this study are available from the corresponding author T.T on request.
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Keisuke Noda and Tetsuro Tominaga mainly designed the study and analyzed the data. Takashi Nonaka, Mitsutoshi Ishii, Hidetoshi Fukuoka, Makoto Hisanaga, Hiroaki Takeshita, Kazuo To, and Kenji Tanaka performed surgery and provided patient care. Terumitsu Sawai and Takeshi Nagayasu supervised this study.
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This research study was conducted retrospectively from data obtained for clinical purposes and was reviewed and approved by the Clinical Research Review Board of Nagasaki University Hospital (approval no. 16062715-5).
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Informed consent was obtained as part of routine care from all individual participants included in the study.
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Noda, K., Tominaga, T., Nonaka, T. et al. Effect of adjuvant chemotherapy after curative resection of colorectal cancer peritoneal metastasis. Int J Colorectal Dis 38, 101 (2023). https://doi.org/10.1007/s00384-023-04407-8
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DOI: https://doi.org/10.1007/s00384-023-04407-8