Annals of Coloproctology

Original Articles

Role of Peritoneal Lavage Cytology and Prediction of Prognosis and Peritoneal Recurrence After Curative Surgery for Colorectal Cancer: Sung Joon Bae, Ui Sup Shin, Young-Jun Ki, Sang Sik Cho, Sun Mi Moon, Sun Hoo Park; Ann Coloproctol. 2014;30(6):266-273. Published online December 31, 2014; DOI: https://doi.org/10.3393/ac.2014.30.6.266

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10 Citations

Purpose

In colorectal cancer, the role of detecting free malignant cells from peritoneal lavage is currently unclear. In this study, we investigated the positive rate of free malignant cells in peritoneal lavage fluid and their predictive value for prognosis and peritoneal recurrence after a curative resection.

Methods

From October 2009 to December 2011, in a prospective manner, we performed cytologic examinations of peritoneal lavage fluid obtained just after the abdominal incision from 145 patients who underwent curative surgery for colorectal cancer. We used proportional hazard regression models to analyze the predictive role of positive cytology for peritoneal recurrence and survival.

Results

Among total 145 patients, six patients (4.1%) showed positive cytology. During the median follow-up of 32 months (range, 8-49 months), 27 patients (18.6%) developed recurrence. Among them, 5 patients (3.4%) showed peritoneal carcinomatosis. In the multivariate analysis, positive cytology was an independent predictive factor for peritoneal recurrence (hazard ratio [HR], 136.5; 95% confidence interval [CI], 12.2-1,531.9; P < 0.0001) and an independent poor prognostic factor for overall survival (HR, 11.4; 95% CI, 1.8-72.0; P = 0.009) and for disease-free survival (HR, 11.1; 95% CI, 3.4-35.8; P < 0.0001).

Conclusion

Positive cytology of peritoneal fluid was significantly associated with peritoneal recurrence and worse survival in patients undergoing curative surgery for colorectal cancer. Peritoneal cytology might be a useful tool for selecting patients who need intraperitoneal or systemic chemotherapy.

Citations

Citations to this article as recorded by

Intraoperative flow cytometry in detecting free carcinoma cells in peritoneal lavage fluid of gastric carcinoma cases
Thulasi Raman Ramalingam, Bharaneedharan Marimuthu, Harsha N. Rasheed, Archana Lakshmanan, Swetha Lakshmi Narla, Lakshman Vaidhyanathan, Ajit Pai
Cytometry Part B: Clinical Cytometry.2025;[Epub] CrossRef
Development and validation of a nomogram to predict overall survival in patients with incidental gallbladder cancer: A retrospective cohort study
Zhi-Hua Xie, Xuebing Shi, Ming-Qi Liu, Jinghan Wang, Yong Yu, Ji-Xiang Zhang, Kai-Jian Chu, Wei Li, Rui-Liang Ge, Qing-Bao Cheng, Xiao-Qing Jiang
Frontiers in Oncology.2023;[Epub] CrossRef
Effect of Intraperitoneal Chemotherapy with Regorafenib on IL-6 and TNF-α Levels and Peritoneal Cytology: Experimental Study in Rats with Colorectal Peritoneal Carcinomatosis
Stefanos Bitsianis, Ioannis Mantzoros, Elissavet Anestiadou, Panagiotis Christidis, Christos Chatzakis, Konstantinos Zapsalis, Savvas Symeonidis, Georgios Ntampakis, Kalliopi Domvri, Anastasia Tsakona, Chryssa Bekiari, Orestis Ioannidis, Stamatios Aggelop
Journal of Clinical Medicine.2023; 12(23): 7267. CrossRef
Conventional peritoneal cytology lacks the prognostic significance of detecting local or peritoneal recurrence in colorectal cancer: An Egyptian experience
Mohamed Shalaby, Tarek S El Baradie, Mohamed Salama, Hebat A M Shaaban, Rasha M Allam, Ehab O.A. Hafiz, Mohamed Aly Abdelhamed, Amr Attia
JGH Open.2021; 5(2): 264. CrossRef
Interleukin 10 level in the peritoneal cavity is a prognostic marker for peritoneal recurrence of T4 colorectal cancer
Seung-Yong Jeong, Byeong Geon Jeon, Ji-Eun Kim, Rumi Shin, Hye Seong Ahn, Heejin Jin, Seung Chul Heo
Scientific Reports.2021;[Epub] CrossRef
Risk factors for developing peritoneal metastases after curative surgery for colorectal cancer: A systematic review and meta‐analysis
Yuanxin Zhang, Xiusen Qin, Wenle Chen, Duo Liu, Jian Luo, Huaiming Wang, Hui Wang
Colorectal Disease.2021; 23(11): 2846. CrossRef
Treatment for Peritoneal Metastasis of Patients With Colorectal Cancer
Young Jin Kim, Chang Hyun Kim
Annals of Coloproctology.2021; 37(6): 425. CrossRef
Pathophysiology of colorectal peritoneal carcinomatosis: Role of the peritoneum
Lieselotte Lemoine, Paul Sugarbaker, Kurt Van der Speeten
World Journal of Gastroenterology.2016; 22(34): 7692. CrossRef
The preoperative platelet to lymphocyte ratio is a prognostic marker in patients with stage II colorectal cancer
Tsuyoshi Ozawa, Soichiro Ishihara, Takeshi Nishikawa, Toshiaki Tanaka, Junichiro Tanaka, Tomomichi Kiyomatsu, Keisuke Hata, Kazushige Kawai, Hiroaki Nozawa, Shinsuke Kazama, Hironori Yamaguchi, Eiji Sunami, Joji Kitayama, Toshiaki Watanabe
International Journal of Colorectal Disease.2015; 30(9): 1165. CrossRef
Intraoperative Peritoneal Lavage: Limitations of Current Evidence for Clinical Implementation
Duck-Woo Kim
Annals of Coloproctology.2014; 30(6): 248. CrossRef

Is Microsatellite Instability Really a Good Prognostic Factor of Colorectal Cancer?: Ui Sup Shin, Sang Sik Cho, Sun Mi Moon, Sun Hoo Park, Sun Hee Jee, Eun-Joo Jung, Dae-Yong Hwang; Ann Coloproctol. 2014;30(1):28-34. Published online February 28, 2014; DOI: https://doi.org/10.3393/ac.2014.30.1.28

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34 Web of Science
26 Citations

Abstract PDF

Purpose

The aim of this study was to investigate the clinicopathologic features of and the prognosis for colorectal cancers (CRCs) with microsatellite instabilities (MSIs).

Methods

Between 2006 and 2009, genotyping was performed on 245 patients with stage II/III CRCs to establish the MSI status. The clinicopathologic differences and the prognostic value of MSI were analyzed. The median follow-up period was 38 months (range, 7-68 months).

Results

Of the total 245 patients, 20 (8.2%) had MSI-high (H) and 225 (91.8%) had MSI-low (L) or stable (S) CRCs. Adjuvant chemotherapies were performed on 101 stage II (87.8%) and 107 stage III patients (82.3%). Patients with MSI-H CRCs more frequently had a family history of colon cancer (10% vs. 2.7%, P = 0.003), more frequently had a cancer located at the proximal colon (90.0% vs. 19.1%, P < 0.0001), and more often showed a mucinous phenotype or poor differentiation (35.0% vs. 7.1%, P = 0.001). Despite less frequent lymph node metastasis (25% vs. 55.6%, P = 0.01), the number of retrieved lymph nodes was higher (26.3 ± 13.1 vs. 20.7 ± 1.2, P = 0.04) in the MSI-H group. The overall survival and the disease-free survival (DFS) did not differ with respect to MSI status. However, in the stage II subgroup, the DFS for patients with MSI-H CRCs was significantly worse (72.2% vs. 90.7%, P = 0.03). The multivariate analysis performed on this subgroup revealed that MSI-H was an independent poor prognostic factor (adjusted hazard ratio, 4.0; 95% confidence interval, 1.0-15.6, P = 0.046).

Conclusion

MSI-H CRCs had distinct clinicopathologic features, and MSI-H was an independent poor prognostic factor in stage II CRCs. Considering the majority of stage II patients were administrated adjuvant chemotherapy, the efficacy of adjuvant chemotherapy for treating MSI CRCs might be different from that for treating MSI-L/S tumors.

Citations

Citations to this article as recorded by

Reassessing the Prognostic Value of Lymph Node Metastasis in Deficient Mismatch Repair Colorectal Cancer
Zilan Ye, Dakui Luo, Fan Chen, Jiayu Chen, Zezhi Shan, Junyong Weng, Yu Zhang, Qingguo Li, Xinxiang Li
Current Oncology.2025; 32(5): 254. CrossRef
Prognostic significance of negative lymph node count in microsatellite instability-high colorectal cancer
Xuan Dai, Zhujiang Dai, Jihong Fu, Zhonglin Liang, Peng Du, Tingyu Wu
World Journal of Surgical Oncology.2024;[Epub] CrossRef
Oncological characteristics, treatments and prognostic outcomes in MMR-deficient colorectal cancer
Wen-Xuan Fan, Fei Su, Yan Zhang, Xiao-Ling Zhang, Yun-Yi Du, Yang-Jun Gao, Wei-Ling Li, Wen-Qing Hu, Jun Zhao
Biomarker Research.2024;[Epub] CrossRef
Exploring the value of multiple preprocessors and classifiers in constructing models for predicting microsatellite instability status in colorectal cancer
Yi Ma, Zhihao Shi, Ying Wei, Feng Shi, Guochu Qin, Zhengyang Zhou
Scientific Reports.2024;[Epub] CrossRef
The prognostic significance of microsatellite instability in colorectal cancer: a Swedish multi-center study
Petri Rantanen, Anne Keränen, Shabane Barot, Sam Ghazi, Annelie Liljegren, Caroline Nordenvall, Annika Lindblom, Ulrik Lindforss
International Journal of Colorectal Disease.2023;[Epub] CrossRef
Preoperative albumin–bilirubin score as a prognostic indicator in patients with stage III colon cancer
Hyun Gu Lee, Seok-Byung Lim, Jong Lyul Lee, Chan Wook Kim, Yong Sik Yoon, In Ja Park, Jin Cheon Kim
Scientific Reports.2022;[Epub] CrossRef
Radiomics features based on internal and marginal areas of the tumor for the preoperative prediction of microsatellite instability status in colorectal cancer
Yi Ma, Changsong Lin, Song Liu, Ying Wei, Changfeng Ji, Feng Shi, Fan Lin, Zhengyang Zhou
Frontiers in Oncology.2022;[Epub] CrossRef
Anatomical Distribution of Colon Cancer: A Retrospective 10-Year Study to Evaluate Rightward Shift in Two Referral Hospitals in Iran
Ahmad R Mafi, Shima Azimi Oliaei, Ramin Heshmat, Hossein Yahyazadeh, Ali G Motlagh
International Journal of Cancer Management.2022;[Epub] CrossRef
Current status on microsatellite instability, prognosis and adjuvant therapy in colon cancer: A nationwide survey of medical oncologists, colorectal surgeons and gastrointestinal pathologists
James W. T. Toh, Hema Mahajan, Pierre Chapuis, Kevin Spring
Cancer Reports.2021;[Epub] CrossRef
Rate of dissemination and prognosis in early and advanced stage colorectal cancer based on microsatellite instability status: systematic review and meta-analysis
James W. T. Toh, Kevin Phan, Faizur Reza, Pierre Chapuis, Kevin J. Spring
International Journal of Colorectal Disease.2021; 36(8): 1573. CrossRef
Computed Tomography-Based Radiomics Model to Preoperatively Predict Microsatellite Instability Status in Colorectal Cancer: A Multicenter Study
Zhi Li, Qi Zhong, Liang Zhang, Minhong Wang, Wenbo Xiao, Feng Cui, Fang Yu, Chencui Huang, Zhan Feng
Frontiers in Oncology.2021;[Epub] CrossRef
Colon cancer patients with mismatch repair deficiency are more likely to present as acute surgical cases
Ioannis Gkekas, Jan Novotny, Tuomas Kaprio, Ines Beilmann-Lehtonen, Pavel Fabian, Sofia Edin, Karin Strigård, Tomas Svoboda, Jaana Hagström, Lucie Barsova, Tomas Jirasek, Caj Haglund, Richard Palmqvist, Ulf Gunnarsson
European Journal of Cancer.2021; 157: 1. CrossRef
Pathological Features and Prognostication in Colorectal Cancer
Kabytto Chen, Geoffrey Collins, Henry Wang, James Wei Tatt Toh
Current Oncology.2021; 28(6): 5356. CrossRef
Prognostic and predictive role of DNA mismatch repair status in stage II‐III colorectal cancer: A systematic review and meta‐analysis
Zhujun Deng, Yun Qin, Jing Wang, Gang Wang, Xiaoqiang Lang, Juan Jiang, Kang Xie, Wengeng Zhang, Heng Xu, Yang Shu, Yan Zhang
Clinical Genetics.2020; 97(1): 25. CrossRef
Implication of Microsatellite Instability in Chinese Cohort of Human Cancers

Meiying Cui, Pan Li, Ying Mao, Lan Zhang, Peiyi Xia, Enjie Liu, Weiwei Wang, Jianying Zhang, Guozhong Jiang, Wencai Li
Cancer Management and Research.2020; Volume 12: 10287. CrossRef
Small RNA expression from viruses, bacteria and human miRNAs in colon cancer tissue and its association with microsatellite instability and tumor location
Robin Mjelle, Wenche Sjursen, Liv Thommesen, Pål Sætrom, Eva Hofsli
BMC Cancer.2019;[Epub] CrossRef
Evaluation of Long-Term Outcomes of Microsatellite Instability Status in an Asian Cohort of Sporadic Colorectal Cancers
Winson Jianhong Tan, Julie Liana Hamzah, Sanchalika Acharyya, Fung Joon Foo, Kiat Hon Lim, Iain Bee Huat Tan, Choong Leong Tang, Min Hoe Chew
Journal of Gastrointestinal Cancer.2018; 49(3): 311. CrossRef
Distinct clinical outcomes of two CIMP-positive colorectal cancer subtypes based on a revised CIMP classification system
Jeong Mo Bae, Jung Ho Kim, Yoonjin Kwak, Dae-Won Lee, Yongjun Cha, Xianyu Wen, Tae Hun Lee, Nam-Yun Cho, Seung-Yong Jeong, Kyu Joo Park, Sae Won Han, Hye Seung Lee, Tae-You Kim, Gyeong Hoon Kang
British Journal of Cancer.2017; 116(8): 1012. CrossRef
Investigation of correlation between mutational status in key EGFR signaling genes and prognosis of stage II colorectal cancer
Li Li, Bei-Bei Ni, Qing-Hua Zhong, Yan-Hui Liu, Ming-Hui Zhang, Ke-Ping Zhang, Dai-Ci Chen, Lei Wang
Future Oncology.2017; 13(17): 1473. CrossRef
Comparison of oncological outcomes of right-sided colon cancer versus left-sided colon cancer after curative resection
Dae Ro Lim, Jung Kul Kuk, Taehyung Kim, Eung Jin Shin
Medicine.2017; 96(42): e8241. CrossRef
Downregulation of acetyl-CoA synthetase 2 is a metabolic hallmark of tumor progression and aggressiveness in colorectal carcinoma
Jeong Mo Bae, Jung Ho Kim, Hyeon Jeong Oh, Hye Eun Park, Tae Hun Lee, Nam-Yun Cho, Gyeong Hoon Kang
Modern Pathology.2017; 30(2): 267. CrossRef
Prognostic relevance of microsatellite instability in pT3N0M0 colon cancer: a population-based study
Francesco Iachetta, Federica Domati, Luca Reggiani-Bonetti, Valeria Barresi, Giulia Magnani, Luigi Marcheselli, Claudia Cirilli, Monica Pedroni
Internal and Emergency Medicine.2016; 11(1): 41. CrossRef
Clinical, histological, and molecular risk factors for cancer recurrence in patients with stage II colon cancer
Yann Touchefeu, Marie Provost-Dewitte, Thierry Lecomte, Alain Morel, Isabelle Valo, Jean-François Mosnier, Céline Bossard, Juliette Eugène, Emilie Duchalais, Jérôme Chetritt, Serge Guyetant, Stéphane Bézieau, Hélène Senellart, Morgane Caulet, Estelle Cauc
European Journal of Gastroenterology & Hepatology.2016; 28(12): 1394. CrossRef
Microsatellite instability is associated with reduced disease specific survival in stage III colon cancer
H.M. Mohan, E. Ryan, I. Balasubramanian, R. Kennelly, R. Geraghty, F. Sclafani, D. Fennelly, R. McDermott, E.J. Ryan, D. O'Donoghue, J.M.P. Hyland, S.T. Martin, P.R. O'Connell, D. Gibbons, Des Winter, K. Sheahan
European Journal of Surgical Oncology (EJSO).2016; 42(11): 1680. CrossRef
Different treatment strategies and molecular features between right-sided and left-sided colon cancers
Hong Shen
World Journal of Gastroenterology.2015; 21(21): 6470. CrossRef
Is a Microsatellite Instability Still Useful for Tailored Treatment in Stage II and III Colon Cancer?
Nam Kyu Kim
Annals of Coloproctology.2014; 30(1): 5. CrossRef

Impact on Prognosis of Lymph Node Micrometastasis and Isolated Tumor Cells in Stage II Colorectal Cancer: Tai Young Oh, Sun Mi Moon, Ui Sup Shin, Hyang Ran Lee, Sun Hoo Park; J Korean Soc Coloproctol. 2011;27(2):71-77. Published online April 30, 2011; DOI: https://doi.org/10.3393/jksc.2011.27.2.71

4,734 View
34 Download
11 Citations

Abstract PDF

Purpose

Even though the importance of micrometastases (MMS) and isolated tumor cells (ITC) has been brought up by many physicians, its impact on the prognosis in stage II colorectal cancer is uncertain. In this research, we tried to investigate the clinical features of MMS and ITC and to prove any correlation with prognosis.

Methods

The research pool was 124 colorectal cancer patients who underwent a curative resection from April 2005 to November 2009. A total of 2,379 lymph nodes (LNs) were examined, and all retrieved LNs were evaluated by immunohistochemical staining with anti-cytokeratin antibody panel. Clinicopathologic parameters and survival rates were compared based on the presence of MMS or ITC and on the micrometastatic lymph node ratio (mmLNR), which is defined as the number of micrometastatic LNs divided by the number of retrieved LNs.

Results

Out of 124 patients (26.6%) 33 were found to have MMS or ITC. There were no significant differences in clinicopathologic features, such as gender, tumor location and size, depth of invasion, histologic grade, except for age (P = 0.04). The three-year disease-free survival rate for the MMS or ITC positive group was 85.7%, and that for MMS and ITC negative group was 92.8% (P = 0.209). The three-year disease-free survival rate for the mmLNR > 0.25 group was 73.3%, and that for the mmLNR ≤ 0.25 group was 92.9% (P = 0.03).

Conclusion

The presence of MMS or ITC was not closely correlated to the prognosis. However, mmLNR is thought to be a valuable marker of prognosis in cases of stage II colorectal cancer.

Citations

Citations to this article as recorded by

Are deeper sections and immunohistochemistry useful in detecting micrometastases and isolated tumour cells in colorectal cancer?
David W. Dodington, Keegan Guidolin, Fayez Quereshy, Runjan Chetty, Stefano Serra, Klaudia M. Nowak
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International Journal of Gynecological Cancer.2019; 29(1): 216. CrossRef
Impact of compliance with an enhanced recovery after surgery pathway on patient outcomes in open gynecologic surgery
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Lymph Node Micrometastasis Cannot be Considered as Positive Lymph Node in Nonmetastatic Colorectal Cancer
Kwang Dae Hong, Jun Won Um, Byung Wook Min, Woong-Bae Ji, Jung-Woo Choi, Young-Sik Kim
The American Surgeon™.2017; 83(2): 127. CrossRef
Lymph node micrometastasis in gastrointestinal tract cancer—a clinical aspect
Shoji Natsugoe, Takaaki Arigami, Yoshikazu Uenosono, Shigehiro Yanagita, Akihiro Nakajo, Masataka Matsumoto, Hiroshi Okumura, Yuko Kijima, Masahiko Sakoda, Yuko Mataki, Yasuto Uchikado, Shinichiro Mori, Kosei Maemura, Sumiya Ishigami
International Journal of Clinical Oncology.2013; 18(5): 752. CrossRef
Prognostic significance of isolated tumor cells in patients with colorectal cancer in recent 10-year studies
YOSHITO AKAGI, TETSUSHI KINUGASA, YOSUKE ADACHI, KAZUO SHIROUZU
Molecular and Clinical Oncology.2013; 1(4): 582. CrossRef
Prognostic significance of histologically detected lymph node micrometastases of sizes between 0.2 and 2 mm in colorectal cancer
Bruno Märkl, C. Herbst, C. Cacchi, T. Schaller, I. Krammer, G. Schenkirsch, A. Probst, H. Spatz
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Molecular Detection of Tumor Cells in Regional Lymph Nodes Is Associated With Disease Recurrence and Poor Survival in Node-Negative Colorectal Cancer: A Systematic Review and Meta-Analysis
Nuh N. Rahbari, Ulrich Bork, Edith Motschall, Kristian Thorlund, Markus W. Büchler, Moritz Koch, Jürgen Weitz
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Prognostic Significance of EpCAM-Positive Disseminated Tumor Cells in Rectal Cancer Patients With Stage I Disease
Sameer Dhayat, Sorina Sorescu, Daniel Vallböhmer, Sebastian Kraus, Stephan Ernst Baldus, Alexander Rehders, Feride Kröpil, Andreas Krieg, Wolfram Trudo Knoefel, Nikolas Hendrik Stoecklein
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Prognostic Signifi cance of the Lymph Node Ratio Regarding Recurrence and Survival in Rectal Cancer Patients Treated with Postoperative Chemoradiotherapy
Ji-Yoon Kim, Su-Mi Chung, Byung-Ock Choi, In-Kyu Lee, Chang-Hyeok An, Jong-Man Won, Mi-Ryeong Ryu
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