R J Lurvink1, C Bakkers1, A Rijken1, F N van Erning2, S W Nienhuijs1, J W Burger1, G J Creemers3, C Verhoef4, V E Lemmens2, I H De Hingh5. 1. Department of Surgical Oncology, Catharina Cancer Institute, Michelangelolaan 2, 5623 EJ, Eindhoven, Netherlands. 2. Department of Research and Development, Netherlands Comprehensive Cancer Organization, Godebaldkwartier 319, 3511 DT, Utrecht, Netherlands. 3. Department of Medical Oncology, Catharina Cancer Institute, Michelangelolaan 2, 5623, Eindhoven, Netherlands. 4. Department of Surgical Oncology, Erasmus Medical Center, Doctor Molewaterplein 40, 3015, Rotterdam, Netherlands. 5. Department of Surgical Oncology, Catharina Cancer Institute, Michelangelolaan 2, 5623 EJ, Eindhoven, Netherlands; GROW - School for Oncology and Developmental Biology, Maastricht University, Universiteitssingel 40, 6229, Maastricht, Netherlands. Electronic address: ignace.d.hingh@catharinaziekenhuis.nl.
Abstract
INTRODUCTION: - To investigate the incidence of, factors associated with, and differences between synchronous and metachronous colorectal peritoneal metastases (CPM) in a population-based cohort. METHODS: - Data from the Netherlands Cancer Registry were used. All patients diagnosed with colorectal cancer (CRC) between 1 January and June 30, 2015 were evaluated for synchronous or metachronous CPM (diagnosis ≤90 or >90 days after surgery for primary CRC), and survival in 2019 (median follow-up 38.4 months). RESULTS: - Of 7233 included patients, 409 (5.7%) were diagnosed with synchronous CPM. Factors associated with synchronous CPM were mucinous (OR 2.72 [1.90-3.90]) or signet ring cell (SRC) histology (OR 6.58 [3.66-11.81]), T4 (OR 4.82 [3.68-6.32]), N1 (OR 1.66 [1.20-2.30]), or N2 stage (OR 3.27 [2.36-4.52]), and synchronous systemic metastases (SM) (OR 3.13 [2.37-4.14]). After surgery for primary CRC, 326 patients developed metachronous CPM after a median time of 14.7 months (3-year cumulative incidence: 5.5%). Factors associated with metachronous CPM were younger age (HR 1.63 [1.10-2.42]), mucinous (HR 1.84 [1.20-2.82]) or SRC histology (HR 2.43 [1.11-5.32]), T4 (HR 2.77 [2.07-3.70]), N1 (HR 2.90 [2.18-3.85]), N2 (HR 3.19 [2.26-4.50]), and synchronous SM (HR 1.95 [1.43-2.66]). CONCLUSION: - This population-based study found the highest incidence of CPM currently reported in literature and a strong association between the presence of synchronous SM and both synchronous and metachronous CPM. These findings may contribute to a tailored approach in the follow-up after primary CRC surgery and guide future clinical trials investigating new strategies regarding risk-reduction or early detection of metachronous CPM.
INTRODUCTION: - To investigate the incidence of, factors associated with, and differences between synchronous and metachronous colorectal peritoneal metastases (CPM) in a population-based cohort. METHODS: - Data from the Netherlands Cancer Registry were used. All patients diagnosed with colorectal cancer (CRC) between 1 January and June 30, 2015 were evaluated for synchronous or metachronous CPM (diagnosis ≤90 or >90 days after surgery for primary CRC), and survival in 2019 (median follow-up 38.4 months). RESULTS: - Of 7233 included patients, 409 (5.7%) were diagnosed with synchronous CPM. Factors associated with synchronous CPM were mucinous (OR 2.72 [1.90-3.90]) or signet ring cell (SRC) histology (OR 6.58 [3.66-11.81]), T4 (OR 4.82 [3.68-6.32]), N1 (OR 1.66 [1.20-2.30]), or N2 stage (OR 3.27 [2.36-4.52]), and synchronous systemic metastases (SM) (OR 3.13 [2.37-4.14]). After surgery for primary CRC, 326 patients developed metachronous CPM after a median time of 14.7 months (3-year cumulative incidence: 5.5%). Factors associated with metachronous CPM were younger age (HR 1.63 [1.10-2.42]), mucinous (HR 1.84 [1.20-2.82]) or SRC histology (HR 2.43 [1.11-5.32]), T4 (HR 2.77 [2.07-3.70]), N1 (HR 2.90 [2.18-3.85]), N2 (HR 3.19 [2.26-4.50]), and synchronous SM (HR 1.95 [1.43-2.66]). CONCLUSION: - This population-based study found the highest incidence of CPM currently reported in literature and a strong association between the presence of synchronous SM and both synchronous and metachronous CPM. These findings may contribute to a tailored approach in the follow-up after primary CRC surgery and guide future clinical trials investigating new strategies regarding risk-reduction or early detection of metachronous CPM.
Authors: Robin J Lurvink; Paulien Rauwerdink; Koen P Rovers; Emma C E Wassenaar; Maarten J Deenen; Joost Nederend; Clément J R Huysentruyt; Iris van 't Erve; Remond J A Fijneman; Erik J R J van der Hoeven; Cornelis A Seldenrijk; Alexander Constantinides; Onno Kranenburg; Maartje Los; Karin H Herbschleb; Anna M J Thijs; Geert-Jan M Creemers; Jacobus W A Burger; Marinus J Wiezer; Simon W Nienhuijs; Djamila Boerma; Ignace H J T de Hingh Journal: BMJ Open Date: 2021-03-30 Impact factor: 2.692
Authors: Robin J Lurvink; Koen P Rovers; Emma C E Wassenaar; Checca Bakkers; Jacobus W A Burger; Geert-Jan M Creemers; Maartje Los; Floortje Mols; Marinus J Wiezer; Simon W Nienhuijs; Djamila Boerma; Ignace H J T de Hingh Journal: Surg Endosc Date: 2021-11-10 Impact factor: 3.453
Authors: Anne G W E Wintjens; Geert A Simkens; Peter-Paul K H Fransen; Narcis Serafras; Kaatje Lenaerts; Gregor H L M Franssen; Ignace H J T de Hingh; Patricia Y W Dankers; Nicole D Bouvy; Andrea Peeters Journal: Clin Exp Metastasis Date: 2022-06-23 Impact factor: 4.510
Authors: Michelle V Dietz; Job P van Kooten; Ibrahim Said; Alexandra R M Brandt-Kerkhof; Cornelis Verhoef; Andreas J A Bremers; Johannes H W de Wilt; Philip R de Reuver; Eva V E Madsen Journal: Ann Surg Oncol Date: 2022-05-05 Impact factor: 4.339
Authors: C Bakkers; R J Lurvink; A Rijken; S W Nienhuijs; N F Kok; G J Creemers; C Verhoef; V E Lemmens; F N van Erning; I H De Hingh Journal: Ann Surg Oncol Date: 2021-06-02 Impact factor: 5.344