1Comprehensive Cancer Center South, Eindhoven, The Netherlands 2Catharina Cancer Center, Department of Surgery, Eindhoven, The Netherlands 3Department of Public Health, Erasmus MC University Medical Centre, Rotterdam, The Netherlands.
Dis Colon Rectum. 2013 Dec;56(12):1373-80. doi: 10.1097/DCR.0b013e3182a62d9d.
Peritoneal carcinomatosis and liver metastases are common metastatic sites in patients who have colorectal cancer. Quite frequently, patients present with both synchronous liver and peritoneal metastases, which may result in a dilemma regarding the optimal treatment.
In the absence of reliable data, the aim of the current study was to provide population-based data on such patients and to review the literature for possible treatment options.
This study is a retrospective analysis of a prospective database and a review.
All patients diagnosed between 1995 and 2010 with synchronous peritoneal carcinomatosis and liver metastases were identified from the Eindhoven Cancer Registry.
Incidence and survival were analyzed. Next, the literature was reviewed for articles reporting on the results of treatment with curative intent.
In total, 27,632 patients were diagnosed with colorectal cancer, of whom 5638 patients (20%) presented with metastasized disease. Synchronous liver metastasis and peritoneal carcinomatosis were present in 440 patients, being 11% of patients with liver metastases, 34% of patients with peritoneal carcinomatosis, 8% of patients with metastasized disease, and 2% of all patients diagnosed with colorectal cancer. Median survival for patients with liver metastasis and peritoneal carcinomatosis was 5 months, in comparison with 95 months for patients with nonmetastasized disease. No improvement in survival was noted over time. None of the patients underwent treatment with curative intent during this period.
No data on the extent of peritoneal carcinomatosis and liver metastases were available in the population-based study. This complicates comparison with treated patients from the literature review, which probably reflects a highly selected patient population.
Both liver metastasis and peritoneal carcinomatosis were present in 8% of patients presenting with metastasized colorectal cancer. Population-based survival was only 5 months, with none of the patients undergoing treatment with curative intent. Median survival rates of up to 36 months after treatment with curative intent as published in the literature may be regarded as promising for selected patients.
腹膜癌和肝转移是结直肠癌患者常见的转移部位。患者经常同时患有肝和腹膜转移，这可能导致最佳治疗方法的选择出现困境。
由于缺乏可靠的数据，本研究的目的是提供此类患者的基于人群的数据，并对文献中的可能治疗选择进行回顾。
这是一项回顾性分析前瞻性数据库和文献综述的研究。
从埃因霍温癌症登记处确定了 1995 年至 2010 年间诊断为同时患有腹膜癌和肝转移的所有患者。
分析发病率和生存率。接下来，对文献进行综述，以查找报告以治愈为目的的治疗结果的文章。
共诊断出 27632 例结直肠癌患者，其中 5638 例（20%）患有转移性疾病。440 例患者同时患有肝转移和腹膜癌，占肝转移患者的 11%，腹膜癌患者的 34%，转移性疾病患者的 8%，以及所有诊断为结直肠癌患者的 2%。同时患有肝转移和腹膜癌的患者的中位生存时间为 5 个月，而非转移性疾病患者的中位生存时间为 95 个月。随着时间的推移，生存率没有提高。在此期间，没有患者接受以治愈为目的的治疗。
在基于人群的研究中，没有关于腹膜癌和肝转移程度的数据。这使得与文献综述中接受治疗的患者进行比较变得复杂，这可能反映了一个高度选择的患者群体。
在患有转移性结直肠癌的患者中，有 8%的患者同时患有肝转移和腹膜癌。基于人群的生存时间仅为 5 个月，且没有患者接受以治愈为目的的治疗。文献中报道的以治愈为目的治疗后的中位生存时间长达 36 个月，这可能被认为是对选定患者有希望的结果。
