Risk factors for developing peritoneal metastases after curative surgery for colorectal cancer: A systematic review and meta-analysis
Yuanxin Zhang
Department of Colorectal Surgery, Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Disease, Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
Search for more papers by this authorXiusen Qin
Department of Colorectal Surgery, Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Disease, Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
Search for more papers by this authorWenle Chen
Department of Colorectal Surgery, Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Disease, Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
Search for more papers by this authorDuo Liu
Department of Colorectal Surgery, Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Disease, Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
Search for more papers by this authorJian Luo
Department of Colorectal Surgery, Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Disease, Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
Search for more papers by this authorCorresponding Author
Huaiming Wang
Department of Colorectal Surgery, Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Disease, Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
Correspondence
Huaiming Wang and Hui Wang, Department of Colorectal Surgery, Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou 510655, China.
Email: [email protected] (Huaiming Wang); [email protected] (Hui Wang)
Search for more papers by this authorCorresponding Author
Hui Wang
Department of Colorectal Surgery, Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Disease, Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
Correspondence
Huaiming Wang and Hui Wang, Department of Colorectal Surgery, Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou 510655, China.
Email: [email protected] (Huaiming Wang); [email protected] (Hui Wang)
Search for more papers by this authorYuanxin Zhang
Department of Colorectal Surgery, Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Disease, Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
Search for more papers by this authorXiusen Qin
Department of Colorectal Surgery, Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Disease, Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
Search for more papers by this authorWenle Chen
Department of Colorectal Surgery, Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Disease, Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
Search for more papers by this authorDuo Liu
Department of Colorectal Surgery, Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Disease, Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
Search for more papers by this authorJian Luo
Department of Colorectal Surgery, Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Disease, Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
Search for more papers by this authorCorresponding Author
Huaiming Wang
Department of Colorectal Surgery, Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Disease, Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
Correspondence
Huaiming Wang and Hui Wang, Department of Colorectal Surgery, Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou 510655, China.
Email: [email protected] (Huaiming Wang); [email protected] (Hui Wang)
Search for more papers by this authorCorresponding Author
Hui Wang
Department of Colorectal Surgery, Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Disease, Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
Correspondence
Huaiming Wang and Hui Wang, Department of Colorectal Surgery, Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou 510655, China.
Email: [email protected] (Huaiming Wang); [email protected] (Hui Wang)
Search for more papers by this authorYuanxin Zhang and Xiusen Qin contributed equally to this work.
Abstract
Aim
Proactive detection and treatment strategies have achieved encouraging survival outcomes for patients with early peritoneal metastases (PM), but these costly and invasive approaches can only be applied to selected high-risk patients. This meta-analysis aimed to identify the risk factors for metachronous PM after curative surgery for colorectal cancer (CRC).
Method
The study was registered at PROSPERO (CRD42020219187). Databases were searched for studies comparing clinical and histopathological characteristics between patients with metachronous peritoneal metastases from colorectal cancer (pmCRC) and patients without (non-pmCRC).
Results
Thirty-six studies were included. Metachronous PM were positively associated with perforation (OR 1.920; 95% CI 1.144–3.223; P = 0.014), poor differentiation (OR 2.291; 1.603–3.275; P < 0.001), T4 (OR 2.897; 1.248–6.726; P = 0.013), N1–2 (OR 3.429; 2.684–4.381; P < 0.001), mucinous adenocarcinoma (OR 4.175; 1.798–9.692; P = 0.001), obstruction (OR 4.467; 1.919–10.398; P = 0.001), synchronous ovarian metastases (OR 5.005; 1.140–21.977; P = 0.033), positive peritoneal carcinoembryonic antigen mRNA (OR 9.472; 3.643–24.631; P < 0.001), elevated serum carcinoembryonic antigen (preoperative group, OR 3.545, 1.486–8.459, P = 0.004; postoperative group, OR 13.673, 2.222–84.129, P = 0.005), elevated serum cancer antigen 19-9 (preoperative group, OR 5.281, 2.146–12.994, P < 0.001; postoperative group, OR 18.646, 6.429–54.083, P < 0.001) and positive peritoneal cytology (OR 25.884; 11.372–58.913; P < 0.001).
Conclusion
These evidence-based risk factors are conducive to designing early detection and proactive treatment strategies, enabling precision medicine.
CONFLICT OF INTEREST
None to disclose.
Open Research
DATA AVAILABILITY STATEMENT
The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.
Supporting Information
| Filename | Description |
|---|---|
| codi15880-sup-0001-FigS1-S6.docxWord document, 10.7 MB | Fig S1-S6 |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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