RT Journal Article
T1 Risk of metachronous peritoneal metastases in patients with pT4a versus pT4b colon cancer: An international multicentre cohort study.
A1 Bastiaenen, Vivian P
A1 Aalbers, Arend G J
A1 Arjona-Sánchez, Alvaro
A1 Bellato, Vittoria
A1 van der Bilt, Jarmila D W
A1 D'Hoore, André D
A1 Espinosa-Redondo, Esther
A1 Klaver, Charlotte E L
A1 Nagtegaal, Iris D
A1 van Ramshorst, Bert
A1 van Santvoort, Hjalmar C
A1 Sica, Giuseppe S
A1 Snaebjornsson, Petur
A1 Wasmann, Karin A T G M
A1 de Wilt, Johannes H W
A1 Wolthuis, Albert M
A1 Tanis, Pieter J
K1 Locally advanced colon cancer
K1 Oncological outcomes
K1 Peritoneal metastases
K1 Survival
K1 T4 colon cancer
AB With evolving treatment strategies aiming at prevention or early detection of metachronous peritoneal metastases (PM), identification of high-risk colon cancer patients becomes increasingly important. This study aimed to evaluate differences between pT4a (peritoneal penetration) and pT4b (invasion of other organs/structures) subcategories regarding risk of PM and other oncological outcomes. From eight databases deriving from four countries, patients who underwent curative intent treatment for pT4N0-2M0 primary colon cancer were included. Primary outcome was the 5-year metachronous PM rate assessed by Kaplan-Meier analysis. Independent predictors for metachronous PM were identified by Cox regression analysis. Secondary endpoints included 5-year local and distant recurrence rates, and 5-year disease free and overall survival (DFS, OS). In total, 665 patients with pT4a and 187 patients with pT4b colon cancer were included. Median follow-up was 38 months (IQR 23-60). Five-year PM rate was 24.7% and 12.2% for pT4a and pT4b categories, respectively (p = 0.005). Independent predictors for metachronous PM were female sex, right-sided colon cancer, peritumoral abscess, pT4a, pN2, R1 resection, signet ring cell histology and postoperative surgical site infections. Five-year local recurrence rate was 14% in both pT4a and pT4b cancer (p = 0.138). Corresponding five-year distant metastases rates were 35% and 28% (p = 0.138). Five-year DFS and OS were 54% vs. 62% (p = 0.095) and 63% vs. 68% (p = 0.148) for pT4a vs. pT4b categories, respectively. Patients with pT4a colon cancer have a higher risk of metachronous PM than pT4b patients. This observation has important implications for early detection and future adjuvant treatment strategies.
YR 2021
FD 2021-05-15
LK http://hdl.handle.net/10668/17830
UL http://hdl.handle.net/10668/17830
LA en
DS RISalud
RD Apr 9, 2025