Retrospective Analysis of Patients with Signet Ring Subtype of Colorectal Cancer with Peritoneal Metastasis Treated with CRS & HIPEC
Abstract
:Simple Summary
Abstract
1. Introduction
2. Results
2.1. Analysis of Predictive Factors
2.2. Tumor Recurrence
3. Discussion
4. Methods
4.1. Treatment and Follow-Up Protocol
4.2. Statistical Analysis
5. Conclusions
Author Contributions
Funding
Conflicts of Interest
Data Availability Statement
References
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Characteristics | Value | |
---|---|---|
Sex (%) | Male | 56.7 (34/60) |
Female | 43.3 (26/60) | |
Age (years) | 51.4 (SD: 13.9) | |
Primary Tumor Location (%) | Cecum | 20 (12/60) |
Ascending colon | 23.3 (14/60) | |
Transverse colon | 8.3 (5/60) | |
Descending colon | 3.3 (2/60) | |
Sigmoid colon | 30 (18/60) | |
Recto-sigmoid | 15 (9/60) | |
Appearance of PM (%) | Synchronous | 60.3 (35/58) |
Metachronous | 39.7 (23/58) | |
Not known | 2 | |
PCI (Mean) | Total PCI | 13.1 (SD: 10.4) |
Small bowel PCI | 3.6 (SD: 3.8) | |
Patients Treated with HIPEC (%) | Yes | 75 (45/60) |
No | 25 (15/60) | |
HIPEC Drug Used (%) | MMC + CDDP | 60 (27/45) |
Oxaliplatin + 5FU | 33.3 (15/45) | |
MMC | 2.2 (1/45) | |
Taxotere + CDDP | 2.2 (1/45) | |
Oxaliplatin | 2.2 (1/45) | |
Mean Surgical Time (min) | 302.6 (SD: 258.8) | |
Mean Blood Loss (mL) | 1457.6 (SD: 1160.5) | |
Mean No. of Blood Units Transfused | 4.4 (SD: 5.7) | |
Completeness of Cytoreduction (%) | CC0 | 61.7 (37/60) |
CC1 | 5 (3/60) | |
CC2 | 13.3 (8/60) | |
CC3 | 20 (12/60) | |
Clavien–Dindo (%) | Grade 0 | 50 (30/60) |
Grade I–II | 23.3 (14/60) | |
Grade III | 13.3 (8/60) | |
Grade IV | 11.7 (7/60) | |
Grade V | 1.7 (1/60) | |
Preoperative Chemotherapy (%) | No Chemotherapy | 1.7 (1/60) |
NACT | 91.7 (55/60) | |
NACT without antibody | 58.9 (32/60) | |
NACT + anti-VEGF antibody | 23.6 (13/55) | |
NACT + anti EGFR antibody | 16.4 (9/55) | |
NACT + multiple targeted drugs | 1.8 (1/55) | |
Biphasic chemotherapy (IV + IP) | 5 (3/60) | |
Biphasic chemotherapy without antibody | 66.6 (2/3) | |
Biphasic chemotherapy + anti-VEGF antibody | 0 (0/3) | |
Biphasic chemotherapy + anti EGFR antibody | 33.3 (1/3) | |
No details | 1.7 (1/60) | |
Postoperative Chemotherapy (%) | No chemotherapy | 1.7 (1/60) |
Systemic chemotherapy | 63.3 (38/60) | |
Systemic chemotherapy without antibody | 50 (19/38) | |
Systemic chemotherapy + anti-VEGF antibody | 26.3 (10/38) | |
Systemic chemotherapy + anti EGFR antibody | 18.4 (7/38) | |
Systemic chemotherapy + multiple targeted drugs | 5.2 (2/38) | |
Biphasic chemotherapy (IV + IP) | 1.7 (1/60) | |
No details | 33.3 (20/60) |
Variable | Category | No. | Median Overall Survival (Months) | Univariate Analysis (p Value) | Multivariate Analysis | ||
---|---|---|---|---|---|---|---|
HR | 95% CI | p Value | |||||
Gender | Female Male | 26 34 | 24.4 (10.1–38.7) 11.8 (8.6– 5.1) | 0.004 | 2.14 | 0.94–4.89 | 0.071 |
Appearance of PM | Synchronous Metachronous | 35 23 | 14.4 (11.9–16.9) 16.7 (7.6–25.7) | 0.960 | |||
HIPEC | HIPEC No HIPEC | 45 15 | 17.3 (16.2–18.4) 5.5 (0–16.1) | 0.007 | 2.20 | 1.01–4.81 | 0.049 |
Complications | No Yes | 30 30 | 17.6 (3.5–31.70) 10.8 (0–23) | 0.006 | |||
CCR | CC0-1 CC2-3 | 40 20 | 17.6 (16.7– 8.5) 4.7 (0–12) | <0.001 | 2.26 | 0.94–5.42 | 0.068 |
Intraoperative Cytology | Negative Positive | 29 22 | 17.6 (13.1–22.1) 9.6 (1.8–17.3) | 0.017 | 1.78 | 0.86–3.71 | 0.122 |
Age | ≤60 years >60 years | 40 20 | 12.9 (9.0–16.8) 17.5 (2.6–32.4) | 0.219 | |||
Nodal status | N0 N+ | 15 45 | 16.9 (12.6–21.2) 12.9 (7.7–18.1) | 0.690 | |||
Side of Primary | Right Left | 31 29 | 14.1 (9.8–18.4) 16.7 (9.6–23.8) | 0.829 | |||
PCI | ≤12 >12 | 32 27 | 17.8 (10.1–25.5) 10.0 (8.4–11.5) | 0.004 | 0.27 | 0.07–1.10 | 0.068 |
Small Bowel PCI | ≤2 >2 | 31 25 | 20.8 (13.1–28.5) 3.5 (5.8–15.5) | <0.001 | 6.51 | 1.65–25.74 | 0.008 |
Blood loss | ≤1000 mL >1000 mL | 22 35 | 17.2 (7.7–26.7) 14.5 (8.9–20.1) | 0.398 | |||
BT | No Yes | 20 28 | 17.3 (13.1–1.5) 14.5 (7.1–22.0) | 0.295 |
References | Total Number of Patients | Patients with Signet Ring Cell | Median OS | 5-Year OS | Mean PCI | CC0/CC1 |
---|---|---|---|---|---|---|
Verwaal et al. 2004 [23] | 102 | 15 | 13 | NR | NR | 49% * |
Chua et al. 2009 [24] | 33 | 15 | 13 | NR | NR | 46.7% |
van Sweringen et al. 2012 [25] | 36 | 5 | 7.2 # | NR | 15 # | 83% * |
Winer et al. 2014 [26] | 67 | 30 | 12.2 | 7% | 11.5 | 77% |
van Oudheusden et al. 2014 [27] | 351 | 20 | 14.1 | NR | NR | 87.5% |
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Prabhu, A.; Brandl, A.; Wakama, S.; Sako, S.; Ishibashi, H.; Mizumoto, A.; Takao, N.; Noguchi, K.; Motoi, S.; Ichinose, M.; et al. Retrospective Analysis of Patients with Signet Ring Subtype of Colorectal Cancer with Peritoneal Metastasis Treated with CRS & HIPEC. Cancers 2020, 12, 2536. https://doi.org/10.3390/cancers12092536
Prabhu A, Brandl A, Wakama S, Sako S, Ishibashi H, Mizumoto A, Takao N, Noguchi K, Motoi S, Ichinose M, et al. Retrospective Analysis of Patients with Signet Ring Subtype of Colorectal Cancer with Peritoneal Metastasis Treated with CRS & HIPEC. Cancers. 2020; 12(9):2536. https://doi.org/10.3390/cancers12092536
Chicago/Turabian StylePrabhu, Aruna, Andreas Brandl, Satoshi Wakama, Shouzou Sako, Haruaki Ishibashi, Akiyoshi Mizumoto, Nobuyuki Takao, Kousuke Noguchi, Shunsuke Motoi, Masumi Ichinose, and et al. 2020. "Retrospective Analysis of Patients with Signet Ring Subtype of Colorectal Cancer with Peritoneal Metastasis Treated with CRS & HIPEC" Cancers 12, no. 9: 2536. https://doi.org/10.3390/cancers12092536