Retrospective Analysis of Patients with Signet Ring Subtype of Colorectal Cancer with Peritoneal Metastasis Treated with CRS & HIPEC
Signet ring cell subtype (SRC) of colorectal cancer (CRC) is a rare subtype and occurs in approximately 1% of all patients with CRC. Patients with peritoneal metastasis (PM) of SRC have a poor prognosis, and this subtype is frequently considered as a contra-indication for extensive surgical treatmen...
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MDPI AG
2020-09-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/12/9/2536 |
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| author | Aruna Prabhu Andreas Brandl Satoshi Wakama Shouzou Sako Haruaki Ishibashi Akiyoshi Mizumoto Nobuyuki Takao Kousuke Noguchi Shunsuke Motoi Masumi Ichinose Yang Liu Yutaka Yonemura |
| author_facet | Aruna Prabhu Andreas Brandl Satoshi Wakama Shouzou Sako Haruaki Ishibashi Akiyoshi Mizumoto Nobuyuki Takao Kousuke Noguchi Shunsuke Motoi Masumi Ichinose Yang Liu Yutaka Yonemura |
| author_sort | Aruna Prabhu |
| collection | DOAJ |
| description | Signet ring cell subtype (SRC) of colorectal cancer (CRC) is a rare subtype and occurs in approximately 1% of all patients with CRC. Patients with peritoneal metastasis (PM) of SRC have a poor prognosis, and this subtype is frequently considered as a contra-indication for extensive surgical treatment. This retrospective study from two dedicated peritoneal surface malignancy centers in Japan included all patients treated with CRS ± hyperthermic intraperitoneal chemotherapy (HIPEC) between July 1994 and December 2017 from a prospectively maintained database. Preoperative, operative, and postoperative parameters were recorded, including complication rates and follow-up. Sixty of the 320 patients treated with CRS due to CRC were diagnosed with SRC subtype. The mean age of the patients was 51.4 years, and the mean peritoneal carcinomatosis index (PCI) was 13.1. Complete cytoreduction was achieved in 61.7% of cases. The postoperative morbidity rate was 25% and the mortality rate was 1.7%. The median overall survival (OS) was 14.4 months. Cox regression analysis revealed small bowel PCI > 2 (hazard ratio (HR) 6.5; <i>p</i> = 0.008) as the most important factor for OS. With accurate patient selection (e.g., PCI ≤ 12 or small bowel PCI ≤ 2), even patients with PM of CRC with SRC subtype may benefit from CRS and HIPEC, with median OS from 17.8 to 20.8 months and 5-year OS of 11.6%. |
| first_indexed | 2024-03-10T16:31:59Z |
| format | Article |
| id | doaj.art-839fb69f074d4d0d9036055c8902acb4 |
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| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-10T16:31:59Z |
| publishDate | 2020-09-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-839fb69f074d4d0d9036055c8902acb42023-11-20T12:47:57ZengMDPI AGCancers2072-66942020-09-01129253610.3390/cancers12092536Retrospective Analysis of Patients with Signet Ring Subtype of Colorectal Cancer with Peritoneal Metastasis Treated with CRS & HIPECAruna Prabhu0Andreas Brandl1Satoshi Wakama2Shouzou Sako3Haruaki Ishibashi4Akiyoshi Mizumoto5Nobuyuki Takao6Kousuke Noguchi7Shunsuke Motoi8Masumi Ichinose9Yang Liu10Yutaka Yonemura11Department of Surgical Oncology, Thangam Cancer Center, Namakkal 637001, Tamil Nadu, IndiaDigestive Unit, Champalimaud Foundation, 1400-038 Lisbon, PortugalDepartment of surgery, Graduate school of medicine, Kyoto University, Kyoto 606-8303, JapanDepartment of Regional Cancer therapy, Peritoneal Surface Malignancy Center, Kishiwada Tokushukai Hospital, Kishiwada, Osaka 596-0042, JapanDepartment of Regional Cancer therapy, Peritoneal Surface Malignancy Center, Kishiwada Tokushukai Hospital, Kishiwada, Osaka 596-0042, JapanDepartment of Regional Cancer Therapy, Peritoneal Surface Malignancy Center, Kusatsu General Hospital, Shiga 525-8585, JapanDepartment of Regional Cancer Therapy, Peritoneal Surface Malignancy Center, Kusatsu General Hospital, Shiga 525-8585, JapanDepartment of Regional Cancer Therapy, Peritoneal Surface Malignancy Center, Kusatsu General Hospital, Shiga 525-8585, JapanDepartment of Regional Cancer Therapy, Peritoneal Surface Malignancy Center, Kusatsu General Hospital, Shiga 525-8585, JapanDepartment of Regional Cancer Therapy, Peritoneal Surface Malignancy Center, Kusatsu General Hospital, Shiga 525-8585, JapanDepartment of Regional Cancer therapy, Peritoneal Surface Malignancy Center, Kishiwada Tokushukai Hospital, Kishiwada, Osaka 596-0042, JapanDepartment of Regional Cancer therapy, Peritoneal Surface Malignancy Center, Kishiwada Tokushukai Hospital, Kishiwada, Osaka 596-0042, JapanSignet ring cell subtype (SRC) of colorectal cancer (CRC) is a rare subtype and occurs in approximately 1% of all patients with CRC. Patients with peritoneal metastasis (PM) of SRC have a poor prognosis, and this subtype is frequently considered as a contra-indication for extensive surgical treatment. This retrospective study from two dedicated peritoneal surface malignancy centers in Japan included all patients treated with CRS ± hyperthermic intraperitoneal chemotherapy (HIPEC) between July 1994 and December 2017 from a prospectively maintained database. Preoperative, operative, and postoperative parameters were recorded, including complication rates and follow-up. Sixty of the 320 patients treated with CRS due to CRC were diagnosed with SRC subtype. The mean age of the patients was 51.4 years, and the mean peritoneal carcinomatosis index (PCI) was 13.1. Complete cytoreduction was achieved in 61.7% of cases. The postoperative morbidity rate was 25% and the mortality rate was 1.7%. The median overall survival (OS) was 14.4 months. Cox regression analysis revealed small bowel PCI > 2 (hazard ratio (HR) 6.5; <i>p</i> = 0.008) as the most important factor for OS. With accurate patient selection (e.g., PCI ≤ 12 or small bowel PCI ≤ 2), even patients with PM of CRC with SRC subtype may benefit from CRS and HIPEC, with median OS from 17.8 to 20.8 months and 5-year OS of 11.6%.https://www.mdpi.com/2072-6694/12/9/2536colorectal cancersignet ring sub-typeperitoneal metastasiscytoreductive surgeryhyperthermic intraperitoneal chemotherapy |
| spellingShingle | Aruna Prabhu Andreas Brandl Satoshi Wakama Shouzou Sako Haruaki Ishibashi Akiyoshi Mizumoto Nobuyuki Takao Kousuke Noguchi Shunsuke Motoi Masumi Ichinose Yang Liu Yutaka Yonemura Retrospective Analysis of Patients with Signet Ring Subtype of Colorectal Cancer with Peritoneal Metastasis Treated with CRS & HIPEC Cancers colorectal cancer signet ring sub-type peritoneal metastasis cytoreductive surgery hyperthermic intraperitoneal chemotherapy |
| title | Retrospective Analysis of Patients with Signet Ring Subtype of Colorectal Cancer with Peritoneal Metastasis Treated with CRS & HIPEC |
| title_full | Retrospective Analysis of Patients with Signet Ring Subtype of Colorectal Cancer with Peritoneal Metastasis Treated with CRS & HIPEC |
| title_fullStr | Retrospective Analysis of Patients with Signet Ring Subtype of Colorectal Cancer with Peritoneal Metastasis Treated with CRS & HIPEC |
| title_full_unstemmed | Retrospective Analysis of Patients with Signet Ring Subtype of Colorectal Cancer with Peritoneal Metastasis Treated with CRS & HIPEC |
| title_short | Retrospective Analysis of Patients with Signet Ring Subtype of Colorectal Cancer with Peritoneal Metastasis Treated with CRS & HIPEC |
| title_sort | retrospective analysis of patients with signet ring subtype of colorectal cancer with peritoneal metastasis treated with crs hipec |
| topic | colorectal cancer signet ring sub-type peritoneal metastasis cytoreductive surgery hyperthermic intraperitoneal chemotherapy |
| url | https://www.mdpi.com/2072-6694/12/9/2536 |
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