Prognostic significance of doubling time in patients undergoing radical surgery for metachronous peritoneal metastases of colorectal cancer

Abstract

PurposeThe doubling times of tumor volume and tumor markers are associated with the prognosis of liver or lung metastases from colorectal cancer (CRC). However, no studies have assessed peritoneal metastases. Therefore, we aimed to elucidate the association between doubling time and the prognosis of patients who underwent radical surgery for metachronous peritoneal metastases of CRC.MethodsWe calculated the tumor doubling times (TDT) of peritoneal metastases and serum carcinoembryonic antigen-doubling times (CEA-DT) in 33 consecutive patients who underwent radical surgery for metachronous peritoneal metastases between January 2006 and April 2017. The impact of short TDT and CEA-DT on overall survival (OS) and relapse-free survival (RFS) was retrospectively reviewed.ResultsIn long TDT (>\u2009137\xa0days) group, the 5-year OS rate was 74.1% and median OS time was 6.6\xa0years. In long CEA-DT (>\u2009102\xa0days) group, the 5-year OS rate was 50.0% and median OS time was 5.6\xa0years. Conversely, in short TDT (≤\u2009137\xa0days) and CEA-DT (≤\u2009102\xa0days) group, the 5-year OS rates and median OS times were both 0.0% and 3.2\xa0years, respectively. In the multivariate analysis, short TDT was an independent risk factor for poor RFS (P\u2009=\u20090.006) and OS (P\u2009=\u20090.010). Similarly, short CEA-DT was also a poor risk factor for RFS (P\u2009<\u20090.001) and OS (P\u2009=\u20090.012).ConclusionsShort TDT and CEA-DT are independent risk factors for poor OS and RFS after surgery for metachronous peritoneal metastases of CRC. TDT and CEA-DT should be considered when selecting candidates for surgical resection.