Significance of Surgical Resection in Patients with Peritoneal Dissemination of Colorectal Cancer with Co-existing Liver and Lung Metastases

Abstract

Objective: To examine whether surgical control of peritoneal dissemination improves patient prognosis in patients with peritoneal dissemination of colorectal cancer with hematogenous metastasis.

Methods: We retrospectively reviewed the outcomes of 55 patients with simultaneous peritoneal dissemination of colorectal cancer who underwent surgical resection (primary site and disseminated site) at Nippon Medical School Hospital, and extracted factors associated with poor prognosis.

Results: Survival tended to be better in patients who underwent surgery without peritoneal dissemination (median survival: 29, 8 months vs. 17, 2 months, P = 0, 09). Patients who could receive postoperative chemotherapy had significantly better survival rate than those who could not (median survival: 30, 5 months vs. 8, 2 months, P < 0.01). Multivariate analysis identified no postoperative chemotherapy as an independent poor prognostic factor (hazard ratio: 0.28, P < 0.01).

Conclusion: Our results suggest that surgical control of peritoneal dissemination may lead to long-term survival in patients who can receive postoperative chemotherapy, even if liver and lung metastases co-exist.