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Overall risk and risk factors for metachronous peritoneal metastasis after colorectal cancer surgery : a nationwide cohort study

Ravn, S. ; Heide-Jørgensen, U. ; Christiansen, C. F. ; Verwaal, V. J. LU ; Hagemann-Madsen, R. H. and Iversen, L. H. (2020) In BJS Open 4(2). p.284-292
Abstract

BACKGROUND: This study aimed to identify the cumulative incidence and risk factors of metachronous peritoneal metastasis (M-PM) from colorectal cancer in patients who had intended curative treatment. METHODS: Patients with colorectal cancer were identified using the Danish Colorectal Cancer Group database for 2006-2015. The Danish Pathology Registry and the Danish National Patient Registry were used to identify M-PM to 2017. Risk factors were estimated by multivariable absolute risk regression, treating death and other cancers as competing risks. Overall risk and risk differences (RDs) were estimated at 1, 3 and 5 years. RESULTS: In 22 586 patients with colorectal cancer, the overall risk of M-PM was reported to be 0·9 (95 per cent c.i.... (More)

BACKGROUND: This study aimed to identify the cumulative incidence and risk factors of metachronous peritoneal metastasis (M-PM) from colorectal cancer in patients who had intended curative treatment. METHODS: Patients with colorectal cancer were identified using the Danish Colorectal Cancer Group database for 2006-2015. The Danish Pathology Registry and the Danish National Patient Registry were used to identify M-PM to 2017. Risk factors were estimated by multivariable absolute risk regression, treating death and other cancers as competing risks. Overall risk and risk differences (RDs) were estimated at 1, 3 and 5 years. RESULTS: In 22 586 patients with colorectal cancer, the overall risk of M-PM was reported to be 0·9 (95 per cent c.i. 0·8 to 1·0) per cent at 1 year, 1·9 (1·8 to 2·1) per cent at 3 years and 2·2 (2·0 to 2·4) per cent at 5 years. Advanced tumour category ((y)pT4 versus (y)pT1) increased the RD of both M-PM (2·9 (95 per cent c.i. 2·1 to 3·7) at 1 year and 6·0 (4·9 to 7·2) at 3 years) and lymph node involvement ((y)pN2 versus (y)pN0) (2·5 (1·8 to 3·2) at year and 4·3 (3·2 to 5·3) at 3 years). No further increase in risk was observed at 5 years. In a subanalysis, tumour-involved resection margin (R1 versus R0) was associated with M-PM with a RD of 3·9 (1·6 to 6·2) at 1 year and 5·9 (2·6 to 9·3) at 3 years. CONCLUSION: The overall risk of M-PM in patients with colorectal cancer is low, but is increased in advanced T and N status. Follow-up of at least 3 years after colorectal cancer surgery may be necessary, given the potential curative treatment of early diagnosed M-PM.

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author
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publishing date
type
Contribution to journal
publication status
published
in
BJS Open
volume
4
issue
2
pages
284 - 292
publisher
Wiley
external identifiers
  • pmid:32207578
  • scopus:85085504616
ISSN
2474-9842
DOI
10.1002/bjs5.50247
language
English
LU publication?
no
additional info
Publisher Copyright: © 2020 The Authors. BJS Open published by John Wiley & Sons Ltd on behalf of BJS Society Ltd.
id
f30217f1-e5f6-47f6-bb1d-6ca268b7de1d
date added to LUP
2022-03-31 12:49:32
date last changed
2024-02-28 15:52:15
@article{f30217f1-e5f6-47f6-bb1d-6ca268b7de1d,
  abstract     = {{<p>BACKGROUND: This study aimed to identify the cumulative incidence and risk factors of metachronous peritoneal metastasis (M-PM) from colorectal cancer in patients who had intended curative treatment. METHODS: Patients with colorectal cancer were identified using the Danish Colorectal Cancer Group database for 2006-2015. The Danish Pathology Registry and the Danish National Patient Registry were used to identify M-PM to 2017. Risk factors were estimated by multivariable absolute risk regression, treating death and other cancers as competing risks. Overall risk and risk differences (RDs) were estimated at 1, 3 and 5 years. RESULTS: In 22 586 patients with colorectal cancer, the overall risk of M-PM was reported to be 0·9 (95 per cent c.i. 0·8 to 1·0) per cent at 1 year, 1·9 (1·8 to 2·1) per cent at 3 years and 2·2 (2·0 to 2·4) per cent at 5 years. Advanced tumour category ((y)pT4 versus (y)pT1) increased the RD of both M-PM (2·9 (95 per cent c.i. 2·1 to 3·7) at 1 year and 6·0 (4·9 to 7·2) at 3 years) and lymph node involvement ((y)pN2 versus (y)pN0) (2·5 (1·8 to 3·2) at year and 4·3 (3·2 to 5·3) at 3 years). No further increase in risk was observed at 5 years. In a subanalysis, tumour-involved resection margin (R1 versus R0) was associated with M-PM with a RD of 3·9 (1·6 to 6·2) at 1 year and 5·9 (2·6 to 9·3) at 3 years. CONCLUSION: The overall risk of M-PM in patients with colorectal cancer is low, but is increased in advanced T and N status. Follow-up of at least 3 years after colorectal cancer surgery may be necessary, given the potential curative treatment of early diagnosed M-PM.</p>}},
  author       = {{Ravn, S. and Heide-Jørgensen, U. and Christiansen, C. F. and Verwaal, V. J. and Hagemann-Madsen, R. H. and Iversen, L. H.}},
  issn         = {{2474-9842}},
  language     = {{eng}},
  number       = {{2}},
  pages        = {{284--292}},
  publisher    = {{Wiley}},
  series       = {{BJS Open}},
  title        = {{Overall risk and risk factors for metachronous peritoneal metastasis after colorectal cancer surgery : a nationwide cohort study}},
  url          = {{http://dx.doi.org/10.1002/bjs5.50247}},
  doi          = {{10.1002/bjs5.50247}},
  volume       = {{4}},
  year         = {{2020}},
}