Tomohiro Adachi1, Takao Hinoi2, Minoru Hattori3, Hiroyuki Egi4, Manabu Shimomura5, Yasufumi Saito6, Hiroyuki Sawada7, Masashi Miguchi8, Hiroaki Niitsu9, Shoichiro Mukai10, Takuya Yano11, Hideki Ohdan12. 1. Department of Gastroenterological and Transplant Surgery Applied Life Sciences, Institute of Biomedical & Health Sciences, Hiroshima University, 1-2-3 Kasumi Minami-ku, Hiroshima, 7348551, Japan. adachitomohiro@hotmail.com. 2. Department of Gastroenterological and Transplant Surgery Applied Life Sciences, Institute of Biomedical & Health Sciences, Hiroshima University, 1-2-3 Kasumi Minami-ku, Hiroshima, 7348551, Japan. thinoi@hiroshima-u.ac.jp. 3. Department of Surgery, Division of Frontier Medical Sciences, Programs for Biomedical Research, Graduate School of Biomedical Sciences, Hiroshima University, Kasumi Minami-ku, Hiroshima, Japan. m-hattori@hiroshima-u.ac.jp. 4. Department of Gastroenterological and Transplant Surgery Applied Life Sciences, Institute of Biomedical & Health Sciences, Hiroshima University, 1-2-3 Kasumi Minami-ku, Hiroshima, 7348551, Japan. hiroegi@yahoo.co.jp. 5. Department of Gastroenterological and Transplant Surgery Applied Life Sciences, Institute of Biomedical & Health Sciences, Hiroshima University, 1-2-3 Kasumi Minami-ku, Hiroshima, 7348551, Japan. manabus761215@gmail.com. 6. Department of Surgery, Division of Frontier Medical Sciences, Programs for Biomedical Research, Graduate School of Biomedical Sciences, Hiroshima University, Kasumi Minami-ku, Hiroshima, Japan. ngywc515@ybb.ne.jp. 7. Department of Surgery, Division of Frontier Medical Sciences, Programs for Biomedical Research, Graduate School of Biomedical Sciences, Hiroshima University, Kasumi Minami-ku, Hiroshima, Japan. dannte5426@yahoo.co.jp. 8. Department of Surgery, Division of Frontier Medical Sciences, Programs for Biomedical Research, Graduate School of Biomedical Sciences, Hiroshima University, Kasumi Minami-ku, Hiroshima, Japan. edajimaheihachi_1@yahoo.co.jp. 9. Department of Gastroenterological and Transplant Surgery Division of Medicine, Program of Medicine, Biomedical Sciences Major, Graduate School of Biomedical & Health Sciences, Hiroshima University, Kasumi Minami-ku, Hiroshima, Japan. hiroaki_niitsu@yahoo.co.jp. 10. Department of Gastroenterological and Transplant Surgery Division of Medicine, Program of Medicine, Biomedical Sciences Major, Graduate School of Biomedical & Health Sciences, Hiroshima University, Kasumi Minami-ku, Hiroshima, Japan. silentman1087@yahoo.co.jp. 11. Department of Gastroenterological and Transplant Surgery Division of Medicine, Program of Medicine, Biomedical Sciences Major, Graduate School of Biomedical & Health Sciences, Hiroshima University, Kasumi Minami-ku, Hiroshima, Japan. yano-tuk@umin.ac.jp. 12. Department of Gastroenterological and Transplant Surgery Applied Life Sciences, Institute of Biomedical & Health Sciences, Hiroshima University, 1-2-3 Kasumi Minami-ku, Hiroshima, 7348551, Japan. hohdan@hiroshima-u.ac.jp.
Abstract
PURPOSE: Few studies have investigated the risk factors in patients with peritoneal carcinomatosis (PC) from colorectal cancer (CRC) who die within 3 months of undergoing surgical intervention and systemic chemotherapy. This study aimed to identify the risk factors associated with the post-treatment 3-month mortality rate. METHODS: Retrospectively collected data from Hiroshima University were analyzed for patients presenting with synchronous PC from CRC between 1992 and 2012. The clinical, histological and survival data were evaluated and correlated with the overall survival rate at 3 months after surgical intervention. RESULTS: In patients who underwent surgical intervention with systemic chemotherapy for synchronous PC from CRC (N = 65), a Kaplan-Meier analysis and the log-rank test revealed that systemic chemotherapy (P = 0.023) and the modified Glasgow Prognostic Score (mGPS) (P = 0.00001) were associated with the 3-month mortality rate. Multivariate analyses using these two factors revealed that the mGPS (0/1, 2) (odds ratio 8.087; 95 % CI 1.512-43.25; P = 0.015) was an independent risk factor for the 3-month mortality rate. CONCLUSION: The mGPS is an important independent predictor of the 3-month mortality rate in patients who undergo surgical intervention with systemic chemotherapy for synchronous PC from CRC. The mGPS could aid surgeons in choosing the appropriate treatment strategy and best care for patients.
PURPOSE: Few studies have investigated the risk factors in patients with peritoneal carcinomatosis (PC) from colorectal cancer (CRC) who die within 3 months of undergoing surgical intervention and systemic chemotherapy. This study aimed to identify the risk factors associated with the post-treatment 3-month mortality rate. METHODS: Retrospectively collected data from Hiroshima University were analyzed for patients presenting with synchronous PC from CRC between 1992 and 2012. The clinical, histological and survival data were evaluated and correlated with the overall survival rate at 3 months after surgical intervention. RESULTS: In patients who underwent surgical intervention with systemic chemotherapy for synchronous PC from CRC (N = 65), a Kaplan-Meier analysis and the log-rank test revealed that systemic chemotherapy (P = 0.023) and the modified Glasgow Prognostic Score (mGPS) (P = 0.00001) were associated with the 3-month mortality rate. Multivariate analyses using these two factors revealed that the mGPS (0/1, 2) (odds ratio 8.087; 95 % CI 1.512-43.25; P = 0.015) was an independent risk factor for the 3-month mortality rate. CONCLUSION: The mGPS is an important independent predictor of the 3-month mortality rate in patients who undergo surgical intervention with systemic chemotherapy for synchronous PC from CRC. The mGPS could aid surgeons in choosing the appropriate treatment strategy and best care for patients.
Entities:
Keywords:
Colorectal cancer; Early mortality; Peritoneal carcinomatosis; Synchronous; The modified glasgow prognostic score (mGPS)
Authors: A G M T Powell; R Wallace; R F McKee; J H Anderson; J J Going; J Edwards; P G Horgan Journal: Colorectal Dis Date: 2012-12 Impact factor: 3.788