. 2020 Aug;27(8):2762-2773.

doi: 10.1245/s10434-020-08327-7. Epub 2020 Mar 13.

Synchronous and Metachronous Peritoneal Metastases in Patients with Left-Sided Obstructive Colon Cancer

Collaborators, Affiliations

Collaborators

Dutch Snapshot Research Group:
H Algera, G D Algie, C S Andeweg, T E Argillander, M N N J Arron, K Arts, T H J Aufenacker, I S Bakker, M van Basten Batenburg, A J N M Bastiaansen, G L Beets, A van den Berg, B van de Beukel, R L G M Blom, B Blomberg, E G Boerma, F C den Boer, W A A Borstlap, N D Bouvy, J E Bouwman, N D A Boye, A R M Brandt-Kerkhof, H T Bransma, A Breijer, W T van den Broek, M E E Bröker, J P M Burbach, E R J Bruns, T A Burghgraef, R M P H Crolla, M Dam, L Daniels, J W T Dekker, A Demirkiran, K W van Dongen, S F Durmaz, A van Esch, J A van Essen, P Fockens, J W Foppen, E J B Furnee, A A W van Geloven, M F Gerhards, E A Gorter, W M U van Grevenstein, J van Groningen, I A J de Groot-van Veen, H E Haak, J W A de Haas, P van Hagen, E E van Halsema, J T H Hamminga, K Havenga, B van den Hengel, E van der Harst, J Heemskerk, J Heeren, B H M Heijnen, L Heijnen, J T Heikens, M van Heinsbergen, D A Hess, N Heuchemer, C Hoff, W Hogendoorn, A P J Houdijk, N Hugen, B Inberg, T L Janssen, D Jean Pierre, W J de Jong, A C H M Jongen, A V Kamman, J M Klaase, W Kelder, E F Kelling, R Klicks, G W De Klein, F W H Kloppenberg, J L M Konsten, L J E R Koolen, V Kornmann, R T J Kortekaas, A Kreiter, B Lamme, J F Lange, T Lettinga, D Lips, G Lo, F Logeman, Y T van Loon, M F Lutke Holzik, C C M Marres, I Masselink, A Mearadji, G Meisen, A G Menon, J W S Merkus, D J L M de Mey, H C J van der Mijle, D E Moes, C J L Molenaar, M J Nieboer, K Nielsen, G A P Nieuwenhuijzen, P A Neijenhuis, P Oomen, N van Oorschot, K Parry, K C M J Peeters, T Paulides, I Paulusma, F B Poelmann, S W Polle, P Poortman, M H Raber, R J Renger, B M M Reiber, R Roukema, W M J de Ruijter, M J A M Russchen, H J T Rutten, J Scheerhoorn, S Scheurs, H Schippers, V N E Schuermans, H J Schuijt, P D Siersema, J C Sierink, C Sietses, R Silvis, J van der Slegt, G D Slooter, M van der Sluis, P van der Sluis, N Smakman, D Smit, A B Smits, T C van Sprundel, D J A Sonneveld, C Steur, J Straatman, M C Struijs, H A Swank, A K Talsma, M Tenhagen, F Ter Borg, J A M G Tol, J L Tolenaar, L Tseng, J B Tuynman, M J F van Veen, S C Veltkamp, A W H van de Ven, L Verkoele, M Vermaas, H P Versteegh, L Verslijs, T Visser, D van Uden, W J Vles, R J de Vos Tot Nederveen Cappel, H S de Vries, S T van Vugt, G Vugts, J A Wegdam, T J Weijs, B J van Wely, M Westerterp, H L van Westreenen, B Wiering, N A T Wijffels, A A Wijkmans, L H Wijngaarden, M van de Wilt, F Wit, E S van der Zaag, D D E Zimmerman, T L R Zwols

Affiliations

¹ Department of Surgery, Amsterdam University Medical Centers, University of Amsterdam, Cancer Centre Amsterdam, Amsterdam, The Netherlands.
² Department of Gastroenterology and Hepatology, Amsterdam University Medical Centers, University of Amsterdam, Cancer Centre Amsterdam, Amsterdam, The Netherlands.
³ Department of Surgery, Meander Medical Center, Amersfoort, The Netherlands.
⁴ Department of Surgery, University Medical Center Utrecht, Utrecht, The Netherlands.
⁵ Department of Surgery, University Medical Center Groningen, Groningen, The Netherlands.
⁶ Department of Surgery, Radboud University Medical Center, Nijmegen, The Netherlands.
⁷ Department of Surgery, Catharina Hospital, Eindhoven, The Netherlands.
⁸ Department of Surgery, Amsterdam University Medical Centers, University of Amsterdam, Cancer Centre Amsterdam, Amsterdam, The Netherlands. p.j.tanis@amsterdamumc.nl.

^# Contributed equally.

PMID: 32170481
PMCID: PMC7334250
DOI: 10.1245/s10434-020-08327-7

Synchronous and Metachronous Peritoneal Metastases in Patients with Left-Sided Obstructive Colon Cancer

Joyce Valerie Veld et al. Ann Surg Oncol. 2020 Aug.

. 2020 Aug;27(8):2762-2773.

doi: 10.1245/s10434-020-08327-7. Epub 2020 Mar 13.

Collaborators

Dutch Snapshot Research Group:
H Algera, G D Algie, C S Andeweg, T E Argillander, M N N J Arron, K Arts, T H J Aufenacker, I S Bakker, M van Basten Batenburg, A J N M Bastiaansen, G L Beets, A van den Berg, B van de Beukel, R L G M Blom, B Blomberg, E G Boerma, F C den Boer, W A A Borstlap, N D Bouvy, J E Bouwman, N D A Boye, A R M Brandt-Kerkhof, H T Bransma, A Breijer, W T van den Broek, M E E Bröker, J P M Burbach, E R J Bruns, T A Burghgraef, R M P H Crolla, M Dam, L Daniels, J W T Dekker, A Demirkiran, K W van Dongen, S F Durmaz, A van Esch, J A van Essen, P Fockens, J W Foppen, E J B Furnee, A A W van Geloven, M F Gerhards, E A Gorter, W M U van Grevenstein, J van Groningen, I A J de Groot-van Veen, H E Haak, J W A de Haas, P van Hagen, E E van Halsema, J T H Hamminga, K Havenga, B van den Hengel, E van der Harst, J Heemskerk, J Heeren, B H M Heijnen, L Heijnen, J T Heikens, M van Heinsbergen, D A Hess, N Heuchemer, C Hoff, W Hogendoorn, A P J Houdijk, N Hugen, B Inberg, T L Janssen, D Jean Pierre, W J de Jong, A C H M Jongen, A V Kamman, J M Klaase, W Kelder, E F Kelling, R Klicks, G W De Klein, F W H Kloppenberg, J L M Konsten, L J E R Koolen, V Kornmann, R T J Kortekaas, A Kreiter, B Lamme, J F Lange, T Lettinga, D Lips, G Lo, F Logeman, Y T van Loon, M F Lutke Holzik, C C M Marres, I Masselink, A Mearadji, G Meisen, A G Menon, J W S Merkus, D J L M de Mey, H C J van der Mijle, D E Moes, C J L Molenaar, M J Nieboer, K Nielsen, G A P Nieuwenhuijzen, P A Neijenhuis, P Oomen, N van Oorschot, K Parry, K C M J Peeters, T Paulides, I Paulusma, F B Poelmann, S W Polle, P Poortman, M H Raber, R J Renger, B M M Reiber, R Roukema, W M J de Ruijter, M J A M Russchen, H J T Rutten, J Scheerhoorn, S Scheurs, H Schippers, V N E Schuermans, H J Schuijt, P D Siersema, J C Sierink, C Sietses, R Silvis, J van der Slegt, G D Slooter, M van der Sluis, P van der Sluis, N Smakman, D Smit, A B Smits, T C van Sprundel, D J A Sonneveld, C Steur, J Straatman, M C Struijs, H A Swank, A K Talsma, M Tenhagen, F Ter Borg, J A M G Tol, J L Tolenaar, L Tseng, J B Tuynman, M J F van Veen, S C Veltkamp, A W H van de Ven, L Verkoele, M Vermaas, H P Versteegh, L Verslijs, T Visser, D van Uden, W J Vles, R J de Vos Tot Nederveen Cappel, H S de Vries, S T van Vugt, G Vugts, J A Wegdam, T J Weijs, B J van Wely, M Westerterp, H L van Westreenen, B Wiering, N A T Wijffels, A A Wijkmans, L H Wijngaarden, M van de Wilt, F Wit, E S van der Zaag, D D E Zimmerman, T L R Zwols

Affiliations

¹ Department of Surgery, Amsterdam University Medical Centers, University of Amsterdam, Cancer Centre Amsterdam, Amsterdam, The Netherlands.
² Department of Gastroenterology and Hepatology, Amsterdam University Medical Centers, University of Amsterdam, Cancer Centre Amsterdam, Amsterdam, The Netherlands.
³ Department of Surgery, Meander Medical Center, Amersfoort, The Netherlands.
⁴ Department of Surgery, University Medical Center Utrecht, Utrecht, The Netherlands.
⁵ Department of Surgery, University Medical Center Groningen, Groningen, The Netherlands.
⁶ Department of Surgery, Radboud University Medical Center, Nijmegen, The Netherlands.
⁷ Department of Surgery, Catharina Hospital, Eindhoven, The Netherlands.
⁸ Department of Surgery, Amsterdam University Medical Centers, University of Amsterdam, Cancer Centre Amsterdam, Amsterdam, The Netherlands. p.j.tanis@amsterdamumc.nl.

^# Contributed equally.

PMID: 32170481
PMCID: PMC7334250
DOI: 10.1245/s10434-020-08327-7

Abstract

Background: Controversy exists on emergency setting as a risk factor for peritoneal metastases (PM) in colon cancer patients. Data in patients with obstruction are scarce. The aim of this study was to determine the incidence of synchronous and metachronous PM, risk factors for the development of metachronous PM, and prognostic implications within a large nationwide cohort of left-sided obstructive colon cancer (LSOCC).

Methods: Patients with LSOCC treated between 2009 and 2016 were selected from the Dutch ColoRectal Audit. Additional treatment and long-term outcome data were retrospectively collected from original patient files in 75 hospitals in 2017.

Results: In total, 3038 patients with confirmed obstruction and without perforation were included. Synchronous PM (at diagnosis or < 30 days postoperatively) were diagnosed in 148/2976 evaluable patients (5.0%), and 3-year cumulative metachronous PM rate was 9.9%. Multivariable Cox regression analyses revealed pT4 stage (HR 1.782, 95% CI 1.191-2.668) and pN2 stage (HR 2.101, 95% CI 1.208-3.653) of the primary tumor to be independent risk factors for the development of metachronous PM. Median overall survival in patients with or without synchronous PM was 20 and 63 months (p < 0.001) and 3-year overall survival of patients that did or did not develop metachronous PM was 48.1% and 77.0%, respectively (p < 0.001).

Conclusion: This population based study revealed a 5.0% incidence of synchronous peritoneal metastases in patients who underwent resection of left-sided obstructive colon cancer. The subsequent 3-year cumulative metachronous PM rate was 9.9%, with advanced tumor and nodal stage as independent risk factors for the development of PM.

PubMed Disclaimer

Conflict of interest statement

We have no competing interests for this specific study. All outside of the submitted work, J.E. van Hooft received a grant from Cook Medicals and a consultancy fee from Boston Scientific and Medtronics. P.D. Siersema receives grant support from Pentax Medical, Norgine, EndoStim and Motus GI, and is on the advisory board of Pentax, Ella-CS and Boston Scientific. I.H.J.T. de Hingh has received unrestricted research funding from QPS/RanD, ROCHE, and the Dutch Cancer Society.

Figures

**Fig. 2**
Overall survival in patients with versus without synchronous peritoneal metastases

**Fig. 3**
Overall survival in patients who did or did not develop metachronous peritoneal metastases as measured from time of primary tumour resection

See this image and copyright information in PMC

References

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Synchronous and Metachronous Peritoneal Metastases in Patients with Left-Sided Obstructive Colon Cancer

Collaborators

Affiliations

Synchronous and Metachronous Peritoneal Metastases in Patients with Left-Sided Obstructive Colon Cancer

Authors

Collaborators

Affiliations

Abstract

Conflict of interest statement

Figures

References

MeSH terms

Grants and funding

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Full Text Sources

Medical