Lymph Node Metastases from Visceral Peritoneal Colorectal Metastases are Associated with Systemic Recurrence

Eran Nizri, Yaniv Berger, Eraan Green, Matan Kyzer, Asaf Aizic, Nadav Nevo, Fabian Gerstenhaber, Joseph M. Klausner, Mordechai Gutman, Guy Lahat, Aviad Hoffman, Ravit Geva

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Visceral peritoneal colorectal metastases (VPCMs) may further metastasize to lymph nodes that drain those organs. The rate of lymph node metastases (LNMs) from VPCMs and their clinical and prognostic significance are unknown. Methods: This study retrospectively analyzed the authors’ institutional databases of 160 patients with peritoneal colorectal metastases who underwent cytoreductive surgery and hyperthermic intraperitoneal chemotherapy. Patients with LNM-VPCM (n = 12) were identified by pathologic reports, and both their short- and long-term outcomes were compared with those of patients without LNM-VPCM. Results: The clinical presentation and primary tumor pathologic characteristics did not differ between the two groups. The patients with LNM-VPCM had a higher tumor burden (measured by the peritoneal carcinomatosis index [PCI]) and visible remnant disease compared with those who had no LNM-VPI (10 vs 5.5 [p = 0.03] vs 33.3% vs 6.8% [p = 0.007], respectively). The postoperative outcomes also were comparable. The patients with LNM-VPCM had a shorter overall survival (OS) than those without LNM-VPCM (median OS, 22.5 months; 95% confidence interval [CI], 15.1–29.9 months vs 40.1 months; 95% CI, 38.1–42 months; p = 0.02). However, only tumor grade and PCI were predictors of OS in the multivariate analysis (hazard ratio [HR], 2.33 [p = 0.001]; 1.77 [p = 0.03], respectively). The study showed that LNM-VPCM was associated with systemic but not peritoneal recurrence compared with non-LNM-VPCM (81.8% vs 51.6% for systemic recurrence, respectively; p = 0.05). Conclusion: The small distinct group of patients defined by LNM-VPCM were prone to systemic recurrence. Given its correlation with systemic recurrence, LNM-VPCM may indicate the need for adjuvant treatment.

Original languageEnglish
Pages (from-to)2069-2075
Number of pages7
JournalAnnals of Surgical Oncology
Volume29
Issue number3
DOIs
StatePublished - Mar 2022

Fingerprint

Dive into the research topics of 'Lymph Node Metastases from Visceral Peritoneal Colorectal Metastases are Associated with Systemic Recurrence'. Together they form a unique fingerprint.

Cite this