Investigating Risk Factors for Developing Peritoneal Carcinomatosis and Recurrence in Patients with T4 Colon Cancer
MacMichael, Andrea J.
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Patients with colon tumors that extend outside of the bowel and invade other organs in the body (T4) are at high risk for developing cancer recurrence and peritoneal carcinomatosis (PC), with a recurrence rate estimated as high as 40%. Due to the terminal nature of PC and the severity of the disease pathology, improving treatment options is of great interest. The aim of this study is to determine the risk of developing PC and recurrence in patients diagnosed with primary T4 colon tumors. A secondary aim is to investigate predictive factors that may lead to the development of recurrent disease. Individual patient data from the Tumor Registry and EPIC medical records system of the Department of Colorectal Surgery at William Beaumont Hospital between 2009 and 2016 was collected and analyzed in a retrospective manner on patients with primary T4 colon tumors who underwent surgical resection. Unpaired t-tests, descriptive statistics, and Pearson chi square tests were performed to compare relationships between characteristics and patient outcomes. In all, 225 patients who underwent curative resection for initially staged T4 colon cancer were studied. The development of PC and recurrence for the patient cohort was 11.1% and 32.4%, respectively. Our study suggests there is an association between many factors and PC or recurrence outcome: differentiation, chemotherapy, TNM staging, perineural invasion, and tumor deposits. Furthermore, our study supports evaluation of preventative treatment options focused on these factors, as well as further study into surgical procedures such as HIPEC that offer curative intent.