Site of Recurrence and Survival After Surgery for Colorectal Peritoneal Metastasis
Abstract Background Multimodal treatment, including systemic treatment and surgery, improved the prognosis of peritoneal metastasis (PM). Despite all efforts, recurrence rates remain high, and little data are available about clinical behavior or molecular patterns of PM in comparison to hematogenous...
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| creator | Breuer, Eva Hebeisen, Monika Schneider, Marcel André Roth, Lilian Pauli, Chantal Frischer-Ordu, Katharina Eden, Janina Pache, Basile Steffen, Thomas Hübner, Martin Villeneuve, Laurent Kepenekian, Vahan Passot, Guillaume Gertsch, Philippe Gupta, Anurag Glehen, Olivier Lehmann, Kuno |
| description | Abstract
Background
Multimodal treatment, including systemic treatment and surgery, improved the prognosis of peritoneal metastasis (PM). Despite all efforts, recurrence rates remain high, and little data are available about clinical behavior or molecular patterns of PM in comparison to hematogenous metastasis. Here, we aimed to analyze recurrence patterns after multimodal treatment for PM from colorectal cancer.
Methods
Patients with colorectal PM undergoing multimodal treatment including systemic chemotherapy and cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy (CRS/HIPEC) between 2005 and 2017 at 4 centers were analyzed retrospectively.
Results
A total of 505 patients undergoing CRS/HIPEC were analyzed. Of the patients, 82.1% received preoperative chemotherapy. Median peritoneal cancer index was 6 (interquartile range = 3-11). Median disease-free and overall survival was 12 (95% confidence interval [CI] = 11 to 14) months and 51 (95% CI = 43 to 62) months, respectively. Disease recurred in 361 (71.5%) patients, presenting as isolated peritoneal recurrence in 24.6%, isolated hematogenous recurrence in 28.3%, and mixed recurrence in 13.9% of patients. Recurrence to the peritoneum was associated with an impaired time from recurrence to death of 21 (95% CI = 18 to 31) months for isolated peritoneal and 22 (95% CI = 16 to 30) months for mixed recurrence, compared with 43 (95% CI = 31 to >121) months for hematogenous recurrence (hazard ratio [HR] = 1.79, 95% CI = 1.27 to 2.53; P = .001; and HR = 2.44, 95% CI = 1.61 to 3.79; P |
| doi_str_mv | 10.1093/jnci/djab001 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2480358593</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><oup_id>10.1093/jnci/djab001</oup_id><sourcerecordid>2576678895</sourcerecordid><originalsourceid>FETCH-LOGICAL-c389t-caa3b836b1da9ff6dbf216c685eca2c759316208c2fa677ea0b35a5ca0de24e53</originalsourceid><addsrcrecordid>eNp9kM9LwzAUx4MoOqc3z1LwoAfr8qNJ0-MY_oKJsum5pOmLtHTNTNrB_ntTNj14MDzIe7wPHx5fhC4IviM4Y5O61dWkrFWBMTlAI5IIHFOC-SEaYUzTWMo0OUGn3tc4vIwmx-iEsUQmXOARWiyrDiJrogXo3jloNUSqLaNl7zbVRjXR1HTghvET3DYy1kUz21gHugvLN3BVZ1sI7Qt0yoeq_Bk6MqrxcL7_x-jj4f599hTPXx-fZ9N5rJnMulgrxQrJREFKlRkjysJQIrSQHLSiOuUZI4JiqalRIk1B4YJxxbXCJdAEOBujm5137exXD77LV5XX0DSqBdv7nCYSMy6DJ6BXf9Da9q4N1-WUp0KkUmaD8HZHaWe9d2DytatWym1zgvMh63zIOt9nHfDLvbQvVlD-wj_hBuB6B9h-_b_qGw5piQI</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2576678895</pqid></control><display><type>article</type><title>Site of Recurrence and Survival After Surgery for Colorectal Peritoneal Metastasis</title><source>MEDLINE</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>Oxford University Press Journals All Titles (1996-Current)</source><source>Alma/SFX Local Collection</source><creator>Breuer, Eva ; Hebeisen, Monika ; Schneider, Marcel André ; Roth, Lilian ; Pauli, Chantal ; Frischer-Ordu, Katharina ; Eden, Janina ; Pache, Basile ; Steffen, Thomas ; Hübner, Martin ; Villeneuve, Laurent ; Kepenekian, Vahan ; Passot, Guillaume ; Gertsch, Philippe ; Gupta, Anurag ; Glehen, Olivier ; Lehmann, Kuno</creator><creatorcontrib>Breuer, Eva ; Hebeisen, Monika ; Schneider, Marcel André ; Roth, Lilian ; Pauli, Chantal ; Frischer-Ordu, Katharina ; Eden, Janina ; Pache, Basile ; Steffen, Thomas ; Hübner, Martin ; Villeneuve, Laurent ; Kepenekian, Vahan ; Passot, Guillaume ; Gertsch, Philippe ; Gupta, Anurag ; Glehen, Olivier ; Lehmann, Kuno</creatorcontrib><description>Abstract
Background
Multimodal treatment, including systemic treatment and surgery, improved the prognosis of peritoneal metastasis (PM). Despite all efforts, recurrence rates remain high, and little data are available about clinical behavior or molecular patterns of PM in comparison to hematogenous metastasis. Here, we aimed to analyze recurrence patterns after multimodal treatment for PM from colorectal cancer.
Methods
Patients with colorectal PM undergoing multimodal treatment including systemic chemotherapy and cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy (CRS/HIPEC) between 2005 and 2017 at 4 centers were analyzed retrospectively.
Results
A total of 505 patients undergoing CRS/HIPEC were analyzed. Of the patients, 82.1% received preoperative chemotherapy. Median peritoneal cancer index was 6 (interquartile range = 3-11). Median disease-free and overall survival was 12 (95% confidence interval [CI] = 11 to 14) months and 51 (95% CI = 43 to 62) months, respectively. Disease recurred in 361 (71.5%) patients, presenting as isolated peritoneal recurrence in 24.6%, isolated hematogenous recurrence in 28.3%, and mixed recurrence in 13.9% of patients. Recurrence to the peritoneum was associated with an impaired time from recurrence to death of 21 (95% CI = 18 to 31) months for isolated peritoneal and 22 (95% CI = 16 to 30) months for mixed recurrence, compared with 43 (95% CI = 31 to >121) months for hematogenous recurrence (hazard ratio [HR] = 1.79, 95% CI = 1.27 to 2.53; P = .001; and HR = 2.44, 95% CI = 1.61 to 3.79; P < .001). On multiple logistic regression analysis, RAS mutational status (odds ratio [OR] = 2.42, 95% CI = 1.11 to 5.47; P = .03) and positive nodal stage of the primary (OR = 3.88, 95% CI = 1.40 to 11.86; P = .01) were identified as predictive factors for peritoneal recurrence.
Conclusions
This study highlights the heterogeneity of peritoneal metastasis in patients with colorectal cancer. Recurrent peritoneal metastasis after radical treatment represents a more aggressive subset of metastatic colorectal cancer.</description><identifier>ISSN: 0027-8874</identifier><identifier>EISSN: 1460-2105</identifier><identifier>DOI: 10.1093/jnci/djab001</identifier><identifier>PMID: 33484560</identifier><language>eng</language><publisher>United States: Oxford University Press</publisher><subject>Antineoplastic Combined Chemotherapy Protocols - therapeutic use ; Cancer ; Chemotherapy ; Colorectal cancer ; Colorectal carcinoma ; Colorectal Neoplasms - pathology ; Combined Modality Therapy ; Confidence intervals ; Cytoreduction Surgical Procedures ; Gastric cancer ; Health services ; Heterogeneity ; Humans ; Hyperthermia, Induced ; Medical prognosis ; Metastases ; Metastasis ; Patients ; Peritoneal Neoplasms - therapy ; Peritoneum ; Peritoneum - pathology ; Prognosis ; Regression analysis ; Retrospective Studies ; Statistical analysis ; Surgery ; Survival ; Survival Rate</subject><ispartof>JNCI : Journal of the National Cancer Institute, 2021-08, Vol.113 (8), p.1027-1035</ispartof><rights>The Author(s) 2021. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com 2021</rights><rights>The Author(s) 2021. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.</rights><rights>The Author(s) 2021. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c389t-caa3b836b1da9ff6dbf216c685eca2c759316208c2fa677ea0b35a5ca0de24e53</citedby><cites>FETCH-LOGICAL-c389t-caa3b836b1da9ff6dbf216c685eca2c759316208c2fa677ea0b35a5ca0de24e53</cites><orcidid>0000-0001-7813-5149 ; 0000-0002-6723-8879 ; 0000-0002-6177-9543 ; 0000-0002-3843-1629 ; 0000-0001-9885-8600</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,1578,27903,27904</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33484560$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Breuer, Eva</creatorcontrib><creatorcontrib>Hebeisen, Monika</creatorcontrib><creatorcontrib>Schneider, Marcel André</creatorcontrib><creatorcontrib>Roth, Lilian</creatorcontrib><creatorcontrib>Pauli, Chantal</creatorcontrib><creatorcontrib>Frischer-Ordu, Katharina</creatorcontrib><creatorcontrib>Eden, Janina</creatorcontrib><creatorcontrib>Pache, Basile</creatorcontrib><creatorcontrib>Steffen, Thomas</creatorcontrib><creatorcontrib>Hübner, Martin</creatorcontrib><creatorcontrib>Villeneuve, Laurent</creatorcontrib><creatorcontrib>Kepenekian, Vahan</creatorcontrib><creatorcontrib>Passot, Guillaume</creatorcontrib><creatorcontrib>Gertsch, Philippe</creatorcontrib><creatorcontrib>Gupta, Anurag</creatorcontrib><creatorcontrib>Glehen, Olivier</creatorcontrib><creatorcontrib>Lehmann, Kuno</creatorcontrib><title>Site of Recurrence and Survival After Surgery for Colorectal Peritoneal Metastasis</title><title>JNCI : Journal of the National Cancer Institute</title><addtitle>J Natl Cancer Inst</addtitle><description>Abstract
Background
Multimodal treatment, including systemic treatment and surgery, improved the prognosis of peritoneal metastasis (PM). Despite all efforts, recurrence rates remain high, and little data are available about clinical behavior or molecular patterns of PM in comparison to hematogenous metastasis. Here, we aimed to analyze recurrence patterns after multimodal treatment for PM from colorectal cancer.
Methods
Patients with colorectal PM undergoing multimodal treatment including systemic chemotherapy and cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy (CRS/HIPEC) between 2005 and 2017 at 4 centers were analyzed retrospectively.
Results
A total of 505 patients undergoing CRS/HIPEC were analyzed. Of the patients, 82.1% received preoperative chemotherapy. Median peritoneal cancer index was 6 (interquartile range = 3-11). Median disease-free and overall survival was 12 (95% confidence interval [CI] = 11 to 14) months and 51 (95% CI = 43 to 62) months, respectively. Disease recurred in 361 (71.5%) patients, presenting as isolated peritoneal recurrence in 24.6%, isolated hematogenous recurrence in 28.3%, and mixed recurrence in 13.9% of patients. Recurrence to the peritoneum was associated with an impaired time from recurrence to death of 21 (95% CI = 18 to 31) months for isolated peritoneal and 22 (95% CI = 16 to 30) months for mixed recurrence, compared with 43 (95% CI = 31 to >121) months for hematogenous recurrence (hazard ratio [HR] = 1.79, 95% CI = 1.27 to 2.53; P = .001; and HR = 2.44, 95% CI = 1.61 to 3.79; P < .001). On multiple logistic regression analysis, RAS mutational status (odds ratio [OR] = 2.42, 95% CI = 1.11 to 5.47; P = .03) and positive nodal stage of the primary (OR = 3.88, 95% CI = 1.40 to 11.86; P = .01) were identified as predictive factors for peritoneal recurrence.
Conclusions
This study highlights the heterogeneity of peritoneal metastasis in patients with colorectal cancer. Recurrent peritoneal metastasis after radical treatment represents a more aggressive subset of metastatic colorectal cancer.</description><subject>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</subject><subject>Cancer</subject><subject>Chemotherapy</subject><subject>Colorectal cancer</subject><subject>Colorectal carcinoma</subject><subject>Colorectal Neoplasms - pathology</subject><subject>Combined Modality Therapy</subject><subject>Confidence intervals</subject><subject>Cytoreduction Surgical Procedures</subject><subject>Gastric cancer</subject><subject>Health services</subject><subject>Heterogeneity</subject><subject>Humans</subject><subject>Hyperthermia, Induced</subject><subject>Medical prognosis</subject><subject>Metastases</subject><subject>Metastasis</subject><subject>Patients</subject><subject>Peritoneal Neoplasms - therapy</subject><subject>Peritoneum</subject><subject>Peritoneum - pathology</subject><subject>Prognosis</subject><subject>Regression analysis</subject><subject>Retrospective Studies</subject><subject>Statistical analysis</subject><subject>Surgery</subject><subject>Survival</subject><subject>Survival Rate</subject><issn>0027-8874</issn><issn>1460-2105</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kM9LwzAUx4MoOqc3z1LwoAfr8qNJ0-MY_oKJsum5pOmLtHTNTNrB_ntTNj14MDzIe7wPHx5fhC4IviM4Y5O61dWkrFWBMTlAI5IIHFOC-SEaYUzTWMo0OUGn3tc4vIwmx-iEsUQmXOARWiyrDiJrogXo3jloNUSqLaNl7zbVRjXR1HTghvET3DYy1kUz21gHugvLN3BVZ1sI7Qt0yoeq_Bk6MqrxcL7_x-jj4f599hTPXx-fZ9N5rJnMulgrxQrJREFKlRkjysJQIrSQHLSiOuUZI4JiqalRIk1B4YJxxbXCJdAEOBujm5137exXD77LV5XX0DSqBdv7nCYSMy6DJ6BXf9Da9q4N1-WUp0KkUmaD8HZHaWe9d2DytatWym1zgvMh63zIOt9nHfDLvbQvVlD-wj_hBuB6B9h-_b_qGw5piQI</recordid><startdate>20210802</startdate><enddate>20210802</enddate><creator>Breuer, Eva</creator><creator>Hebeisen, Monika</creator><creator>Schneider, Marcel André</creator><creator>Roth, Lilian</creator><creator>Pauli, Chantal</creator><creator>Frischer-Ordu, Katharina</creator><creator>Eden, Janina</creator><creator>Pache, Basile</creator><creator>Steffen, Thomas</creator><creator>Hübner, Martin</creator><creator>Villeneuve, Laurent</creator><creator>Kepenekian, Vahan</creator><creator>Passot, Guillaume</creator><creator>Gertsch, Philippe</creator><creator>Gupta, Anurag</creator><creator>Glehen, Olivier</creator><creator>Lehmann, Kuno</creator><general>Oxford University Press</general><general>Oxford Publishing Limited (England)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TO</scope><scope>7U7</scope><scope>7U9</scope><scope>C1K</scope><scope>H94</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-7813-5149</orcidid><orcidid>https://orcid.org/0000-0002-6723-8879</orcidid><orcidid>https://orcid.org/0000-0002-6177-9543</orcidid><orcidid>https://orcid.org/0000-0002-3843-1629</orcidid><orcidid>https://orcid.org/0000-0001-9885-8600</orcidid></search><sort><creationdate>20210802</creationdate><title>Site of Recurrence and Survival After Surgery for Colorectal Peritoneal Metastasis</title><author>Breuer, Eva ; Hebeisen, Monika ; Schneider, Marcel André ; Roth, Lilian ; Pauli, Chantal ; Frischer-Ordu, Katharina ; Eden, Janina ; Pache, Basile ; Steffen, Thomas ; Hübner, Martin ; Villeneuve, Laurent ; Kepenekian, Vahan ; Passot, Guillaume ; Gertsch, Philippe ; Gupta, Anurag ; Glehen, Olivier ; Lehmann, Kuno</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c389t-caa3b836b1da9ff6dbf216c685eca2c759316208c2fa677ea0b35a5ca0de24e53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</topic><topic>Cancer</topic><topic>Chemotherapy</topic><topic>Colorectal cancer</topic><topic>Colorectal carcinoma</topic><topic>Colorectal Neoplasms - pathology</topic><topic>Combined Modality Therapy</topic><topic>Confidence intervals</topic><topic>Cytoreduction Surgical Procedures</topic><topic>Gastric cancer</topic><topic>Health services</topic><topic>Heterogeneity</topic><topic>Humans</topic><topic>Hyperthermia, Induced</topic><topic>Medical prognosis</topic><topic>Metastases</topic><topic>Metastasis</topic><topic>Patients</topic><topic>Peritoneal Neoplasms - therapy</topic><topic>Peritoneum</topic><topic>Peritoneum - pathology</topic><topic>Prognosis</topic><topic>Regression analysis</topic><topic>Retrospective Studies</topic><topic>Statistical analysis</topic><topic>Surgery</topic><topic>Survival</topic><topic>Survival Rate</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Breuer, Eva</creatorcontrib><creatorcontrib>Hebeisen, Monika</creatorcontrib><creatorcontrib>Schneider, Marcel André</creatorcontrib><creatorcontrib>Roth, Lilian</creatorcontrib><creatorcontrib>Pauli, Chantal</creatorcontrib><creatorcontrib>Frischer-Ordu, Katharina</creatorcontrib><creatorcontrib>Eden, Janina</creatorcontrib><creatorcontrib>Pache, Basile</creatorcontrib><creatorcontrib>Steffen, Thomas</creatorcontrib><creatorcontrib>Hübner, Martin</creatorcontrib><creatorcontrib>Villeneuve, Laurent</creatorcontrib><creatorcontrib>Kepenekian, Vahan</creatorcontrib><creatorcontrib>Passot, Guillaume</creatorcontrib><creatorcontrib>Gertsch, Philippe</creatorcontrib><creatorcontrib>Gupta, Anurag</creatorcontrib><creatorcontrib>Glehen, Olivier</creatorcontrib><creatorcontrib>Lehmann, Kuno</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Toxicology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>JNCI : Journal of the National Cancer Institute</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Breuer, Eva</au><au>Hebeisen, Monika</au><au>Schneider, Marcel André</au><au>Roth, Lilian</au><au>Pauli, Chantal</au><au>Frischer-Ordu, Katharina</au><au>Eden, Janina</au><au>Pache, Basile</au><au>Steffen, Thomas</au><au>Hübner, Martin</au><au>Villeneuve, Laurent</au><au>Kepenekian, Vahan</au><au>Passot, Guillaume</au><au>Gertsch, Philippe</au><au>Gupta, Anurag</au><au>Glehen, Olivier</au><au>Lehmann, Kuno</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Site of Recurrence and Survival After Surgery for Colorectal Peritoneal Metastasis</atitle><jtitle>JNCI : Journal of the National Cancer Institute</jtitle><addtitle>J Natl Cancer Inst</addtitle><date>2021-08-02</date><risdate>2021</risdate><volume>113</volume><issue>8</issue><spage>1027</spage><epage>1035</epage><pages>1027-1035</pages><issn>0027-8874</issn><eissn>1460-2105</eissn><abstract>Abstract
Background
Multimodal treatment, including systemic treatment and surgery, improved the prognosis of peritoneal metastasis (PM). Despite all efforts, recurrence rates remain high, and little data are available about clinical behavior or molecular patterns of PM in comparison to hematogenous metastasis. Here, we aimed to analyze recurrence patterns after multimodal treatment for PM from colorectal cancer.
Methods
Patients with colorectal PM undergoing multimodal treatment including systemic chemotherapy and cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy (CRS/HIPEC) between 2005 and 2017 at 4 centers were analyzed retrospectively.
Results
A total of 505 patients undergoing CRS/HIPEC were analyzed. Of the patients, 82.1% received preoperative chemotherapy. Median peritoneal cancer index was 6 (interquartile range = 3-11). Median disease-free and overall survival was 12 (95% confidence interval [CI] = 11 to 14) months and 51 (95% CI = 43 to 62) months, respectively. Disease recurred in 361 (71.5%) patients, presenting as isolated peritoneal recurrence in 24.6%, isolated hematogenous recurrence in 28.3%, and mixed recurrence in 13.9% of patients. Recurrence to the peritoneum was associated with an impaired time from recurrence to death of 21 (95% CI = 18 to 31) months for isolated peritoneal and 22 (95% CI = 16 to 30) months for mixed recurrence, compared with 43 (95% CI = 31 to >121) months for hematogenous recurrence (hazard ratio [HR] = 1.79, 95% CI = 1.27 to 2.53; P = .001; and HR = 2.44, 95% CI = 1.61 to 3.79; P < .001). On multiple logistic regression analysis, RAS mutational status (odds ratio [OR] = 2.42, 95% CI = 1.11 to 5.47; P = .03) and positive nodal stage of the primary (OR = 3.88, 95% CI = 1.40 to 11.86; P = .01) were identified as predictive factors for peritoneal recurrence.
Conclusions
This study highlights the heterogeneity of peritoneal metastasis in patients with colorectal cancer. Recurrent peritoneal metastasis after radical treatment represents a more aggressive subset of metastatic colorectal cancer.</abstract><cop>United States</cop><pub>Oxford University Press</pub><pmid>33484560</pmid><doi>10.1093/jnci/djab001</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0001-7813-5149</orcidid><orcidid>https://orcid.org/0000-0002-6723-8879</orcidid><orcidid>https://orcid.org/0000-0002-6177-9543</orcidid><orcidid>https://orcid.org/0000-0002-3843-1629</orcidid><orcidid>https://orcid.org/0000-0001-9885-8600</orcidid><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Oxford University Press Journals All Titles (1996-Current); Alma/SFX Local Collection |
| subjects | Antineoplastic Combined Chemotherapy Protocols - therapeutic use Cancer Chemotherapy Colorectal cancer Colorectal carcinoma Colorectal Neoplasms - pathology Combined Modality Therapy Confidence intervals Cytoreduction Surgical Procedures Gastric cancer Health services Heterogeneity Humans Hyperthermia, Induced Medical prognosis Metastases Metastasis Patients Peritoneal Neoplasms - therapy Peritoneum Peritoneum - pathology Prognosis Regression analysis Retrospective Studies Statistical analysis Surgery Survival Survival Rate |
| title | Site of Recurrence and Survival After Surgery for Colorectal Peritoneal Metastasis |
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