Differences in patient- and tumor characteristics, treatment and survival between patients with screen-detected versus clinically detected colorectal peritoneal metastases

L J K Galanos ¹, A Rijken ¹, M A G Elferink ²

¹Department of Surgery, Catharina Hospital, Eindhoven, the Netherlands; Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, the Netherlands.
²Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, the Netherlands.
³Department of Surgery, St. Antonius Hospital, Utrecht, the Netherlands.
⁴Department of Surgery, Erasmus MC, Rotterdam, the Netherlands.
⁵Department of Surgery, Radboud University Hospital, Nijmegen, the Netherlands.
⁶Department of Surgery, Amsterdam University Hospital, Amsterdam, the Netherlands.
⁷Department of Surgery, Netherlands Cancer Institute, Amsterdam, the Netherlands.
⁸Department of Surgery, Groningen University Hospital, Groningen, the Netherlands.
⁹Department of Surgery, Utrecht University Hospital, Utrecht, the Netherlands.
¹⁰Department of Pathology, Catharina Hospital, Eindhoven, the Netherlands.
¹¹Department of Surgery, Catharina Hospital, Eindhoven, the Netherlands; Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, the Netherlands; GROW- School for Oncology and Development Biology, Maastricht University, Maastricht, the Netherlands.

⁰Department of Surgery, Catharina Hospital, Eindhoven, the Netherlands; Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, the Netherlands.

European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology +

|

November 5, 2024

View abstract on PubMed

Summary

Colorectal cancer screening improves survival. Patients with screen-detected synchronous colorectal peritoneal metastases (CPM) received more curative treatment and had significantly better overall survival (OS) than those with clinically detected CPM.

Area Of Science

Oncology
Gastroenterology
Public Health

Background

Colorectal cancer (CRC) screening aims to enhance cancer-specific survival.
Synchronous colorectal peritoneal metastases (CPM) represent a significant challenge in CRC management.
Understanding detection methods is crucial for optimizing patient outcomes.

Purpose Of The Study

To compare patient and tumor characteristics, treatment, and survival for screen-detected versus clinically detected synchronous CPM.
To evaluate the impact of screening on outcomes in a Dutch population-based cohort.

Main Methods

Utilized data from the Netherlands Cancer Registry (NCR) linked with the Dutch Nationwide Pathology Databank (Palga).
Included patients aged 55-75 diagnosed with synchronous CPM between 2014-2020.
Compared baseline characteristics and treatment using chi-squared tests; overall survival (OS) analyzed with log-rank tests and multivariable Cox regression.

Main Results

Out of 2,773 patients with synchronous CPM, 7% were screen-detected.
Screen-detected CPM patients were more likely to receive cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) (28% vs. 14%).
Median OS was significantly longer for screen-detected CPM (20.0 months) versus clinically detected CPM (10.8 months), with an adjusted HR of 0.68 (95% CI [0.57-0.81]).

Conclusions

Screen-detected CPM patients more frequently received treatment with curative intent.
Screening for colorectal cancer is associated with improved overall survival in patients with synchronous peritoneal metastases.