Peritoneal recurrence after resection for Stage I–III colorectal cancer: A population analysis

BACKGROUND: Colorectal cancer (CRC) often recurs in the peritoneum, although the pattern of peritoneal recurrence (PR) has received less attention. We sought to describe the presentation and risk factors for PR following CRC resection. METHODS: We performed a cohort study of patients undergoing resection of Stage I–III CRC from 2006 to 2007 using merged data from a Commission on Cancer Special Study and the National Cancer Database. We estimated the timing, method of detection, and risk factors for isolated PR. RESULTS: Here, 8991 patients were included and isolate PR occurred in 77 (0.9%) patients. The median time to PR was 16.2 months (intrquartile range = 9.3–28.0 months) and most patients were identified via new symptoms (36.4%). Pathologic factors associated with increased odds of PR included higher T stage (T3 vs. T2, odds ratio [OR] = 4.8, 95% confidence interval [CI] = 1.5–15.7), N stage (N1 vs. N0, OR = 2.00, CI = 1.1–3.7), and signet ring (OR = 8.2, CI = 3.0–22.3) or mucinous histology (OR = 2.6, CI = 1.5–4.7). CONCLUSIONS: The majority of PR was detected within 18 months and few were identified by surveillance. Advanced T/N stage and signet ring/mucinous histology were associated with increased odds of PR.