Risk factors of synchronous peritoneal metastases in colorectal cancer: a meta-analysis

Abstract

\n Background: Early detection of synchronous colorectal peritoneal metastasis (CPM) is difficult due to the absence of typical symptoms and the low accuracy of imaging examinations. Better knowledge of risk factors for synchronous CPM may be essential for early diagnosis and strengthening management. This study aimed to clarify the risk factors. Methods: This meta-analysis was based on PRISMA guidelines. A systematic search of PubMed, Embase and Cochrane Library databases was performed. The pooled data was assessed by a random-effects model. Results: 25 studies containing 171932 patients were included. Synchronous CPM was associated positively with female (OR 1.299; 1.118 to 1.509; P = 0.001), T4 (OR 12.331; 7.734 to 19.660; P < 0.001), N1-2 (OR 5.665; 3.628 to 8.848; P < 0.001), poorly differentiated grade (OR 2.560; 1.537 to 4.265; P < 0.001), right-sided colon cancer (OR 2.468; 2.050 to 2.970; P < 0.001), mucinous adenocarcinoma (OR 3.565; 2.095 to 6.064; P < 0.001), signet-ring cell carcinoma (OR 4.480; 1.836 to 10.933; P = 0.001), elevated serum CA19-9 (OR 12.868; 5.196 to 31.867; P < 0.001), PROK1/PROKR2-positive (OR 2.244; 1.031 to 4.884; P = 0.042) and BRAF mutations (OR 2.586; 1.674 to 3.994; P < 0.001). However, it’s associated negatively with rectal cancer and non-mucinous adenocarcinoma, and not associated with KRAS, NRAS, PIK3CA mutations and MSI-H/dMMR. Conclusions: These risk factors are the alerts that could predict the presence of synchronous CPM and contribute to strengthening management and optimal therapeutic strategy.