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Peer-reviewedCC BY-NC-NDJournal of the anus, rectum and colon

Surgical Impact on Postoperative Morbidity in Colorectal Cancer with Peritoneal Metastasis: A Multicenter Prospective Observational Study.

  • Naoyuki Toyota1
  • Heita Ozawa1,2
  • Hirotoshi Kobayashi3,4
  • Kenjiro Kotake5
  • Masayasu Kawasaki6
  • Yukihide Kanemitsu7
  • Yusuke Kinugasa8
  • Hideki Ueno9
  • Kotaro Maeda10
  • Takeshi Suto11
  • Kenichi Sugihara12
  • Yoichi Ajioka13
13 affiliations
  1. 1Department of Colorectal Surgery, Tochigi Cancer Center, Tochigi, Japan.
  2. 2Department of Surgery, Utsunomiya Memorial Hospital, Tochigi, Japan.
  3. 3Department of Surgery, Tokyo Metropolitan Hiroo Hospital, Tokyo, Japan.
  4. 4Department of Surgery, Teikyo University Hospital, Mizonokuchi, Kanagawa, Japan.
  5. 5Department of Surgery, Sano City Hospital, Tochigi, Japan.
  6. 6Department of Surgery, Bell Land General Hospital, Sakai, Japan.
  7. 7Department of Colorectal Surgery, National Cancer Center Hospital, Tokyo, Japan.
  8. 8Department of Gastrointestinal Surgery, Institute of Science Tokyo, Tokyo, Japan.
  9. 9Department of Surgery, National Defense Medical College, Tokorozawa, Japan.
  10. 10International Medical Center, Fujita Health University Hospital, Toyoake, Japan.
  11. 11Department of Gastroenterological Surgery, Yamagata Prefectural Central Hospital, Yamagata, Japan.
  12. 12Institute of Science Tokyo, Tokyo, Japan.
  13. 13Division of Molecular and Diagnostic Pathology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan.
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Abstract

The objective of this study was to identify the factors influencing postoperative morbidity in patients with colorectal cancer (CRC) and synchronous peritoneal metastasis (PM). This multicenter prospective observational study was conducted by the Japanese Society for Cancer of the Colon and Rectum. Patients with CRC and synchronous PM were recruited from 28 institutions in Japan between October 2012 and December 2016. Postoperative morbidity was the primary endpoint of the analysis, and diverse variables were included for evaluation via logistic regression analysis. A total of 137 patients, including 78 men and 59 women, were enrolled in this study. The median age was 67 years. Among patients with synchronous PM, 55 had PM alone, classified as M1c1, whereas 82 had PM with metastases to other organs, classified as M1c2. In multivariate analysis, M1c2 status and operation time >170 minutes were significantly associated with postoperative morbidity (odds ratio [OR] = 3.89, 95% confidence interval [CI] 1.31-11.51, p = 0.01; and OR = 4.56, 95% CI 1.32-11.51, p = 0.01, respectively). In the overall cohort, postoperative morbidity was not significantly associated with overall survival. This study demonstrated that M1c2 is an independent risk factor for postoperative morbidity. When planning surgery for peritoneal metastasis, particularly in patients with distant organ metastases, the elevated risk of postoperative morbidity should be carefully considered in surgical decision-making.

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Cite

BibTeXRIS
BibTeX
@article{toyota2026surgical,
  title = {{Surgical Impact on Postoperative Morbidity in Colorectal Cancer with Peritoneal Metastasis: A Multicenter Prospective Observational Study.}},
  author = {Naoyuki Toyota and Heita Ozawa and Hirotoshi Kobayashi and Kenjiro Kotake and Masayasu Kawasaki and Yukihide Kanemitsu and Yusuke Kinugasa and Hideki Ueno and Kotaro Maeda and Takeshi Suto and Kenichi Sugihara and Yoichi Ajioka},
  journal = {Journal of the anus, rectum and colon},
  year = {2026},
  month = oct,
  doi = {10.23922/jarc.2026-011},
  url = {https://europepmc.org/article/MED/42952862},
  note = {CC BY-NC-ND},
}
RIS
TY  - JOUR
TI  - Surgical Impact on Postoperative Morbidity in Colorectal Cancer with Peritoneal Metastasis: A Multicenter Prospective Observational Study.
AU  - Naoyuki Toyota
AU  - Heita Ozawa
AU  - Hirotoshi Kobayashi
AU  - Kenjiro Kotake
AU  - Masayasu Kawasaki
AU  - Yukihide Kanemitsu
AU  - Yusuke Kinugasa
AU  - Hideki Ueno
AU  - Kotaro Maeda
AU  - Takeshi Suto
AU  - Kenichi Sugihara
AU  - Yoichi Ajioka
PY  - 2026
DA  - 2026/10/25
JO  - Journal of the anus, rectum and colon
DO  - 10.23922/jarc.2026-011
UR  - https://europepmc.org/article/MED/42952862
AB  - The objective of this study was to identify the factors influencing postoperative morbidity in patients with colorectal cancer (CRC) and synchronous peritoneal metastasis (PM). This multicenter prospective observational study was conducted by the Japanese Society for Cancer of the Colon and Rectum. Patients with CRC and synchronous PM were recruited from 28 institutions in Japan between October 2012 and December 2016. Postoperative morbidity was the primary endpoint of the analysis, and diverse variables were included for evaluation via logistic regression analysis. A total of 137 patients, including 78 men and 59 women, were enrolled in this study. The median age was 67 years. Among patients with synchronous PM, 55 had PM alone, classified as M1c1, whereas 82 had PM with metastases to other organs, classified as M1c2. In multivariate analysis, M1c2 status and operation time >170 minutes were significantly associated with postoperative morbidity (odds ratio [OR] = 3.89, 95% confidence interval [CI] 1.31-11.51, p = 0.01; and OR = 4.56, 95% CI 1.32-11.51, p = 0.01, respectively). In the overall cohort, postoperative morbidity was not significantly associated with overall survival. This study demonstrated that M1c2 is an independent risk factor for postoperative morbidity. When planning surgery for peritoneal metastasis, particularly in patients with distant organ metastases, the elevated risk of postoperative morbidity should be carefully considered in surgical decision-making.
SN  - 2432-3853
ER  -