イタバシ ミチオ   Itabashi Michio
  板橋 道朗
   所属   医学部 医学科
   職種   特任教授
論文種別 原著
言語種別 英語
査読の有無 査読なし
表題 Factors affecting R0 resection of colorectal cancer with synchronous peritoneal metastases: a multicenter prospective observational study by the Japanese Society for Cancer of the Colon and Rectum.
掲載誌名 正式名:International journal of clinical oncology
略  称:Int J Clin Oncol
ISSNコード:14377772/13419625
掲載区分国内
巻・号・頁 25(2),pp.330-337
著者・共著者 Shida Dai, Kobayashi Hirotoshi, Kameyama Masao, Hase Kazuo, Maeda Kotaro, Suto Takeshi, Itabashi Michio, Funahashi Kimihiko, Koyama Fumikazu, Ozawa Heita, Noura Shingo, Ishida Hideyuki, Kanemitsu Yukihide, Kotake Kenjiro, Sugihara Kenichi
発行年月 2020/02
概要 BACKGROUND:In Japan, R0 resection has been recommended for colorectal cancer patients with peritoneal metastases confined to the adjacent peritoneum and those with a few metastases to the distant peritoneum. R0 resection for M1c disease has drawn attention in Western countries and is currently considered an acceptable therapeutic option in the US National Comprehensive Cancer Network guidelines. However, clinical factors that affect the choice of R0 resection are unknown.METHODS:This multicenter, prospective, observational study was conducted by the Japanese Society for Cancer of the Colon and Rectum. Colorectal cancer patients with synchronous peritoneal metastases were enrolled at 28 institutions in Japan from October 2012 to December 2016. To determine factors affecting R0 resection and R1 resection with intended R0 resection, stepwise logistic regression analyses were performed on clinical factors including age, sex, performance status (PS), body mass index, peritoneal cancer index (PCI) score, presence of ascites, presence of distant metastases, and primary tumor site.RESULTS:R0/R1 resection was performed in 36 (31/5; 25%) of 146 patients. No distant metastases [odds ratio (OR) 52.9; 95% confidence interval (CI) 13.3-210.1; p < 0.0001], low PCI score (1-6) (OR 20.0; 95% CI 4.8-83.4; p < 0.0001), and high PS (0) (OR 2.40; 95% CI 0.66-8.68; p = 0.18) were independent factors affecting R0/R1 resection. PCI score and PS were also independent factors affecting R0/R1 resection in M1c patients without non-peritoneal distant metastases (n = 59).CONCLUSION:Distant metastases, PCI score, and PS are three factors which affect R0 resection for M1c disease.
DOI 10.1007/s10147-019-01562-3
PMID 31677019