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Title
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Retrospective evaluation of the prognostic value of histological growth pattern in patients with colorectal peritoneal metastases undergoing curative-intent cytoreductive surgery
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Author
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Abstract
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| Background. Two distinct histological growth patterns (HGPs) were described in patients with peritoneal metastasis of colorectal cancer origin (PMCRC) with limited Peritoneal Cancer Index (PCI) <= 6 who did not receive neoadjuvant chemotherapy (NAC) and were treated with cytoreductive surgery (CRS) +/- hyperthermic intraperitoneal chemotherapy (HIPEC): pushing HGP (P-HGP) and infiltrating HGP (I-HGP). Patients with dominant P-HGP (> 50%) had significantly better disease-free survival (DFS) and overall survival (OS). Objective. We aimed to determine whether these previous observations regarding the prognostic value of HGP in patients with PMCRC with low PCI (<= 6) are also valid in all operable patients, regardless of whether they received NAC or not and regardless of PCI score. Methods. This was a retrospective study including 76 patients who underwent complete CRS +/- HIPEC for PMCRC between July 2012 and March 2019. In each patient, up to five of the largest excised peritoneal nodules were analyzed for their tumor-to-peritoneum interface. Correlations between NAC, HGP, and prognosis were further explored. Results. Thirty-seven patients (49%) had dominant P-HGP and 39 (51%) had dominant I-HGP. On univariate analysis, patients with P-HGP <= 50% had significantly lower OS than those with dominant P-HGP > 50% (39 versus 60 months; p = 0.014) confirmed on multivariate analysis (hazard ratio 2.4, 95% confidence interval 1.3-4.5; p = 0.006). There were no significant associations between NAC and type of HGP. Conclusions. This study confirms the prognostic value and reproducibility of the two previously reported HGPs in PMCRC. Dominant P-HGP is associated with better DFS and OS in patients undergoing curative-intent CRS +/- HIPEC compared with I-HGP, independently of the extent of peritoneal disease burden. |
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Language
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English
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Source (journal)
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Annals of surgical oncology. - New York, N.Y., 1994, currens
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Publication
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New york
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Springer
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2024
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ISSN
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1068-9265
[print]
1534-4681
[online]
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DOI
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10.1245/S10434-024-15125-Y
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Volume/pages
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31
(2024)
, p. 3778-3784
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ISI
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001185849900002
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Pubmed ID
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38491312
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Full text (Publisher's DOI)
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Full text (open access)
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