Back to Search
Start Over
Lymph Node Metastases from Visceral Peritoneal Colorectal Metastases are Associated with Systemic Recurrence.
- Source :
-
Annals of surgical oncology [Ann Surg Oncol] 2022 Mar; Vol. 29 (3), pp. 2069-2075. Date of Electronic Publication: 2021 Oct 07. - Publication Year :
- 2022
-
Abstract
- Background: Visceral peritoneal colorectal metastases (VPCMs) may further metastasize to lymph nodes that drain those organs. The rate of lymph node metastases (LNMs) from VPCMs and their clinical and prognostic significance are unknown.<br />Methods: This study retrospectively analyzed the authors' institutional databases of 160 patients with peritoneal colorectal metastases who underwent cytoreductive surgery and hyperthermic intraperitoneal chemotherapy. Patients with LNM-VPCM (n = 12) were identified by pathologic reports, and both their short- and long-term outcomes were compared with those of patients without LNM-VPCM.<br />Results: The clinical presentation and primary tumor pathologic characteristics did not differ between the two groups. The patients with LNM-VPCM had a higher tumor burden (measured by the peritoneal carcinomatosis index [PCI]) and visible remnant disease compared with those who had no LNM-VPI (10 vs 5.5 [p = 0.03] vs 33.3% vs 6.8% [p = 0.007], respectively). The postoperative outcomes also were comparable. The patients with LNM-VPCM had a shorter overall survival (OS) than those without LNM-VPCM (median OS, 22.5 months; 95% confidence interval [CI], 15.1-29.9 months vs 40.1 months; 95% CI, 38.1-42 months; p = 0.02). However, only tumor grade and PCI were predictors of OS in the multivariate analysis (hazard ratio [HR], 2.33 [p = 0.001]; 1.77 [p = 0.03], respectively). The study showed that LNM-VPCM was associated with systemic but not peritoneal recurrence compared with non-LNM-VPCM (81.8% vs 51.6% for systemic recurrence, respectively; p = 0.05).<br />Conclusion: The small distinct group of patients defined by LNM-VPCM were prone to systemic recurrence. Given its correlation with systemic recurrence, LNM-VPCM may indicate the need for adjuvant treatment.<br /> (© 2021. Society of Surgical Oncology.)
- Subjects :
- Antineoplastic Combined Chemotherapy Protocols therapeutic use
Combined Modality Therapy
Cytoreduction Surgical Procedures
Humans
Lymphatic Metastasis
Prognosis
Retrospective Studies
Survival Rate
Colorectal Neoplasms drug therapy
Hyperthermia, Induced
Percutaneous Coronary Intervention
Peritoneal Neoplasms drug therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1534-4681
- Volume :
- 29
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Annals of surgical oncology
- Publication Type :
- Academic Journal
- Accession number :
- 34622371
- Full Text :
- https://doi.org/10.1245/s10434-021-10869-3