Postoperative peritoneal metastases within 2 years in patients with T4 colon cancer:analysis of risk factors and clinical therapeutic strategies

WANG Ye; LI Shu-yuan; LOU Zheng

doi:10.19538/j.cjps.issn1005-2208.2024.10.16

Abstract：Objective To investigate the factors influencing peritoneal metastases in patients with non-metastatic stage T4 colon cancer within 2 years after surgery and summarize the clinical therapeutic strategies.Methods Retrospectively analyze the clinical and pathological data of 292 patients with non-metastatic T4 colon cancer,who underwent colectomy at the First Affiliated Hospital of Naval Medical University from January 1,2015,to December 31,2021.Cox regression was used to analyze factors affecting peritoneal metastasis within 2 years after surgery.Results The univariate analysis showed that BMI≥30 and BMI ranging from 25 to 30,postoperative pathological N-stage,tumor deposits status,embolism of vascular cancer,BRAF genotype,and surgical method were associated with peritoneal metastasis within 2 years after surgery(P＜0.05).The multivariate analysis showed that BMI≥30(HR=4.881,95％CI 1.272-18.735,P=0.021),BMI ranging from 25.0 to 30(HR=3.040,95％CI 1.286-7.184,P=0.011),and positive embolism of vascular cancer(HR=4.105,95％CI 1.830-9.210,P=0.001)were independent risk factors for peritoneal metastases within 2 years after surgery.Positive tumor deposits(HR=2.135,95％CI 0.995-4.586,P=0.052)and laparoscopic surgical approach(HR=2.061,95％CI 0.951-4.460,P=0.067)were potential independent risk factors for peritoneal metastasis within 2 years after surgery.Conclusion The laparoscopic surgical approach should be carefully selected for patients with non-metastatic T4 stage colon cancer.For non-metastatic T4 colon cancer patients with BMI≥25,positive embolism of vascular cancer,or positive tumor deposits,regular postoperative and close monitoring for peritoneal metastases should be applied for early treatment and improved prognosis.