High Risk Cases of Peritoneal Recurrence after Resection for Colorectal Cancer

Wataru Adachi, Shoichiro Koike, Yoshinori Nimura, Shinji Nakata, Yoshiro Fujimori, Shoji Kajikawa, Takai Kuroda, Futoshi Iida

Department of Surgery, Shinshu University School of Medicine

To clarify the group at high risk for peritoneal recurrence after resection for colorectal cancer, 30 patients with peritoneal dissemination and 279 without dissemination were comparatively studied. Furthermore, the rates of peritoneal and hepatic recurrence were investigated in 170 patients who had undergone potentially curative resection for colorectal cancer. Significant differences in many clinicopathological factors were observed between the groups with and without dissemination: location of tumor, longitudinal diameter, % circumferential diameter, macroscopic and microscopic types of tumor, macroscopic and microscopic depths of invasion, lymph node metastasis, lymphatic vessel invasion, and preoperative serum CEA level. The rate of peritoneal recurrence was more than 25%, which was higher than the rate of hepatic recurrence in patients with colorectal cancer of types 2, 3 or 4, more than 75% in circumferential diameter, and with serosal invasion. The rate of peritoneal recurrence was not strongly influenced by additional factors, such as serum CEA level, longitudinal diameter of tumor, lymph node metastasis, and histologic type of tumor. From these results, patients with tumors of type 2, 3 or 4, more than 75% in circumferential diameter and with serosal invasion are considered to be at high risk for peritoneal recurrence after surgery for colorectal cancer.

Key words
colorectal cancer, peritoneal recurrence, hepatic recurrence, risk factor of peritoneal dissemination

Reprint requests
Wataru Adachi Department of Surgery, Shinshu University School of Medicine
3-1-1 Asahi, Matsumoto, 390 JAPAN

Accepted
April 5, 1995

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