Surgical Outcomes and Prognostic Factors of Colorectal Cancer with Peritoneal Carcinomatosis Undergoing Primary Tumor Resection

Abstract

Purpose: We assessed the surgical outcomes and prognostic factors of colorectal cancer (CRC) cases with peritoneal carcinomatosis who underwent primary tumor resection (PTR). Materials and Methods: Patients with colorectal adenocarcinoma who underwent treatment at our department between 2000 and 2010 were reviewed. Result: Of 1,484 patients with CRC, 77 patients (5.2%) presented with peritoneal carcinomatosis. 74 patients of CRC patients with peritoneal carcinomatosis underwent PTR, and curativity B resection (Cur B: without macroscopic residual tumor) was performed in 12 patients. Of 65 CRC patients with peritoneal carcinomatosis who underwent curativity C resection (Cur C: with macroscopic residual tumors), the overall survival rate was significantly higher in 62 patients with PTR than three patients without PTR. Of 74 patients with peritoneal carcinomatosis who underwent PTR, 32 patients were categorized as P1, 17 patients as P2, and 25 patients as P3. The 3-year overall survival rate (median survival time) of the patients with P1, P2 and P3 was 34.4% (20.2 months), 41.2% (24.7 months) and 8.0 % (14.8 months), respectively. The survival rate was significantly lower in P3 patients than in P1 patients and in P2 patients (P=0.008, P=0.008). Multivariate analysis showed that histological type (poorly differentiated adenocarcinoma, mucinous carcinoma and signet-ring cell carcinoma), P3 and Cur C were significant prognostic factors affecting overall survival (P<0.001, P=0.015, P=0.002). Conclusion: This study suggests that the complete curative resection of primary tumor and peritoneal carcinomatosis could improve outcomes in patients with colorectal cancer with peritoneal carcinomatosis.