Abstract
Introduction
– This population-based study aimed to investigate incidence, risk factors, treatment,
and survival of synchronous peritoneal metastases (PM) of hepatobiliary origin.
Methods
– All Dutch patients diagnosed with hepatobiliary cancer between 2009 and 2018 were
selected. Factors associated with PM were identified with logistic regression analyses.
Treatments for patients with PM were categorized into local therapy, systemic therapy,
and best supportive care (BSC). Overall survival (OS) was investigated using log-rank
test.
Results
– In total, 12 649 patients were diagnosed with hepatobiliary cancer of whom 8% (n = 1066)
were diagnosed with synchronous PM (12% [n = 882/6519] in biliary tract cancer [BTC]
vs. 4% [n = 184/5248] in hepatocellular carcinoma [HCC]). Factors that were positively
associated with PM were the female sex (OR 1.18, 95% CI 1.03–1.35), BTC (OR 2.93,
95% CI 2.46–3.50), diagnosis in more recent years (2013–2015: OR 1.42, 95% CI 1.20–1.68;
2016–2018: OR 1.48, 95% CI 1.26–1.75), T3/T4 stage (OR 1.84, 95% CI 1.55–2.18), N1/N2
stage (OR 1.31, 95% CI 1.12–1.53) and other synchronous systemic metastases (OR 1.85,
95% CI 1.62–2.12). Of all PM patients, 723 (68%) received BSC only. Median OS was
2.7 months (IQR 0.9–8.2) in PM patients.
Conclusion
– Synchronous PM were found in 8% of all hepatobiliary cancer patients and occurred
more often in BTC than in HCC. Most patients with PM received BSC only. Given the
high incidence and dismal prognosis of PM patients, extended research in hepatobiliary
PM is needed to achieve better outcome in these patients.
Keywords
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References
- Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries.CA Cancer J Clin. 2021; 71: 209-249https://doi.org/10.3322/caac.21660
- Trends in treatment and survival of gallbladder cancer in The Netherlands; identifying gaps and opportunities from a nation-wide cohort.Cancers. 2020; 12https://doi.org/10.3390/cancers12040918
- Cholangiocarcinoma landscape in Europe: diagnostic, prognostic and therapeutic insights from the ENSCCA Registry.J Hepatol. 2022; 76: 1109-1121https://doi.org/10.1016/j.jhep.2021.12.010
- Trends in incidence, diagnosis, treatment and survival of hepatocellular carcinoma in a low-incidence country: data from The Netherlands in the period 2009-2016.Eur J Cancer. 2020; 137: 214-223https://doi.org/10.1016/j.ejca.2020.07.008
- Trends in the incidence and management of biliary tract cancer: a French population-based study.J Hepatol. 2011; 54: 306-310https://doi.org/10.1016/j.jhep.2010.06.039
- Distant metastases in patients with intrahepatic cholangiocarcinoma: does location matter? A retrospective analysis of 370 patients.JAMA Oncol. 2020; (2020)https://doi.org/10.1155/2020/7195373
- Sorafenib in advanced hepatocellular carcinoma.N Engl J Med. 2008; 359: 378-390https://doi.org/10.1056/nejmoa0708857
- Cisplatin plus gemcitabine versus gemcitabine for biliary tract cancer.N Engl J Med. 2010; 362: 1273-1281https://doi.org/10.1056/nejmoa0908721
- Clinical manifestations and survival of hepatocellular carcinoma patients with peritoneal metastasis.J Gastroenterol Hepatol. 2009; 24: 815-820https://doi.org/10.1111/j.1440-1746.2009.05848.x
- Treatment and survival of resected and unresected distal cholangiocarcinoma: a nationwide study.Acta Oncol. 2019; 58: 1048-1055https://doi.org/10.1080/0284186x.2019.1590634
- Report of the 19th follow-up survey of primary liver cancer in Japan.Hepatol Res. 2016; 46: 372-390https://doi.org/10.1111/hepr.12697
- 8-year follow-up of randomized trial: cytoreduction and hyperthermic intraperitoneal chemotherapy versus systemic chemotherapy in patients with peritoneal carcinomatosis of colorectal cancer.Ann Surg Oncol. 2008; 15: 2426-2432https://doi.org/10.1245/s10434-008-9966-2
- Hyperthermic intraperitoneal chemotherapy in ovarian cancer.N Engl J Med. 2018; 378: 230-240https://doi.org/10.1056/nejmoa1708618
- Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy improves survival of patients with peritoneal carcinomatosis from gastric cancer: final results of a phase III randomized clinical trial.Ann Surg Oncol. 2011; 18: 1575-1581https://doi.org/10.1245/s10434-011-1631-5
- Hepatocellular carcinoma: Dutch guideline for surveillance, diagnosis and therapy.Neth J Med. 2014; 72: 299-304https://doi.org/10.1245/s10434-011-1631-5
- Bile duct cancer (cholangiocarcinoma) treatment (PDQ®): health professional version.PDQ Cancer Information Summaries, 2002https://www.ncbi.nlm.nih.gov/books/NBK65869/Date accessed: February 20, 2023
- The need for a rapid and comprehensive adoption of the revised European standard population in cancer incidence comparisons.Eur J Cancer Prev. 2017; 26: 447-452https://doi.org/10.1097/cej.0000000000000250
- Guidelines for the diagnosis and treatment of cholangiocarcinoma: an update.Gut. 2012; 61: 1657-1669https://doi.org/10.1136/gutjnl-2011-301748
- Clinicopathological factors and long-term outcome comparing between lung and peritoneal metastasectomy after hepatectomy for hepatocellular carcinoma in a tertiary institution.Surgery. 2015; 157: 645-653https://doi.org/10.1016/j.surg.2014.07.024
- Resection of peritoneal implantation from hepatocellular carcinoma.Ann Surg Oncol. 2002; 9: 863-868https://doi.org/10.1007/bf02557522
- Peritoneal carcinomatosis risk and long-term survival following hepatectomy for spontaneous hepatocellular carcinoma rupture: results of a multicenter French study (French-AFC).Ann Surg Oncol. 2020; 27: 3383-3392https://doi.org/10.1245/s10434-020-08442-5
- Exploring the role of resection of extrahepatic metastases from hepatocellular carcinoma.Surg Oncol. 2012; 21: 95-101https://doi.org/10.1016/j.suronc.2011.01.005
- Ruptured hepatocellular carcinoma evokes risk of implanted metastases.J Surg Oncol. 1989; 41: 183-186https://doi.org/10.1002/jso.2930410310
- Detection of needle tract implantation and peritoneal seeding after radiofrequency ablation using intraoperative near-infrared fluorescence system for recurrent hepatocellular carcinoma: a case report.Surg Case Rep. 2018; 4https://doi.org/10.1186/s40792-018-0485-5
- Increased risk of tumor seeding after percutaneous radiofrequency ablation for single hepatocellular carcinoma.Hepatology. 2001; 33: 1124-1129https://doi.org/10.1053/jhep.2001.24233
- Increase in the incidence of synchronous and metachronous peritoneal metastases in patients with colorectal cancer: a nationwide study.Eur J Surg Oncol. 2021; 47: 1026-1033https://doi.org/10.1016/j.ejso.2020.11.135
- The metastatic pattern of intestinal and diffuse type gastric carcinoma - a Dutch national cohort study.Cancer Epidemiol. 2020; 69https://doi.org/10.1016/j.canep.2020.101846
- Diagnosis and staging of hepatobiliary malignancies: potential incremental value of (18)F-FDG-PET/MRI compared to MRI of the liver.Nuklearmedizin. 2021; 60: 355-367https://doi.org/10.1055/a-1486-3671
Ayuso C, Rimola J, Vilana R, Burrel M, Darnell A, Garcia-Criado A, et al. Diagnosis and staging of hepatocellular carcinoma (HCC): current guidelines. Eur J Radiol. 2018;101:72-81. https://doi.org/10.1016/j.ejrad.2018.01.025.
- Is there an oncological interest in the combination of CRS/HIPEC for peritoneal carcinomatosis of HCC? Results of a multicenter international study.Eur J Surg Oncol. 2018; 44: 1786-1792https://doi.org/10.1016/j.ejso.2018.05.021
- Cytoreductive surgery and HIPEC improve survival compared to palliative chemotherapy for biliary carcinoma with peritoneal metastasis: a multi-institutional cohort from PSOGI and BIG RENAPE groups.Eur J Surg Oncol. 2018; 44: 1378-1383https://doi.org/10.1016/j.ejso.2018.04.023
- Cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy vs. cytoreductive surgery alone for intrahepatic cholangiocarcinoma with peritoneal metastases: a retrospective cohort study.Eur J Surg Oncol. 2021; 47: 2363-2368https://doi.org/10.1016/j.ejso.2021.05.014
- The emergence of pressurized intraperitoneal aerosol chemotherapy as a palliative treatment option for patients with diffuse peritoneal metastases: a narrative review.J Gastrointest Oncol. 2021; 12: S259-S270https://doi.org/10.21037/jgo-20-497
- Pressurised intraperitoneal aerosol chemotherapy: rationale, evidence, and potential indications.Lancet Oncol. 2019; 20: e368-e377https://doi.org/10.1016/s1470-2045(19)30318-3
- Recurrence of hepatocellular cancer after resection: patterns, treatments, and prognosis.Ann Surg. 2015; 261: 947-955https://doi.org/10.1097/sla.0000000000000710
- Infectious complications after surgery for perihilar cholangiocarcinoma: a single Western center experience.Surgery. 2022; 172https://doi.org/10.1016/j.surg.2022.04.028
- Hepatocellular carcinoma with extrahepatic metastasis: clinical features and prognostic factors.Cancer. 2011; 117: 4475-4483https://doi.org/10.1002/cncr.25960
Article info
Publication history
Published online: March 05, 2023
Accepted:
March 2,
2023
Received in revised form:
February 21,
2023
Received:
January 17,
2023
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2023 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.
