title: Risk factors for peritoneal dissemination of colorectal cancer.
abstract: OBJECTIVE
  The aim of this study was to clarify the risk factors associated with positive peritoneal dissemination (PPD) of colorectal cancer (CRC).
  
  
  METHODS
  From June 2000 to September 2002, 143 CRC patients who underwent elective curative (79.0%) or non-curative (21.0%) open laparotomy were prospectively studied. Clinical evaluations including classical factors, colonoscopic evaluation, intraoperative evaluation, and pathological features were recorded. PPD was diagnosed when macro- (MAPD) or microscopic peritoneal dissemination (MIPD) was evident. Positive peritoneal cytology from initially existing ascites or washing lavage indicated MIPD. Various factors were analyzed with univariate (Chi-square test) and then multivariate analyses (logistic regression test) to search for the risk factors of PPD.
  
  
  RESULTS
  Overall, MIPD, MAPD, and PPD were found in 2.8%, 6.3%, and 9.1%, respectively. Univariate analysis identified age (< or =59 years), CA19-9 (> or = 34.6 U/ml), poor differentiation, circumferential involvement (> or = 3 quadrants), ascites volume (>80 ml), pN+, and pT4 as risk factors of PPD. PPD did not occur in patients with well-differentiated tumors, less circumferential involvement (< 2 quadrants), or no lymph node metastasis. After multivariate analysis, CA19-9 (Odds ratio (95% CI), 8.6 (1.7-43.1)), pT4 (9.0 (1.3-61.0)), and age (5.26 (1.1-25.0)) remained significant risk factors.
  
  
  CONCLUSIONS
  CA19-9 (> or = 34.6 U/ml), pT4, and age (< or =59 years) were significant risk factors of PPD.
authors.affiliation: Division of Colon and Rectal Surgery, Department of Surgery, Taipei, Taiwan, Republic of China. yangsh@vghtpe.gov.tw
authors.forename: Shung-Haur
authors.initials: SH
authors.lastname: Yang
authors.forename: Jen-Kou
authors.initials: JK
authors.lastname: Lin
authors.forename: Chiung-Ru
authors.initials: CR
authors.lastname: Lai
authors.forename: Chien-Chih
authors.initials: CC
authors.lastname: Chen
authors.forename: A Fen-Yau
authors.initials: AF
authors.lastname: Li
authors.forename: Wen-Yih
authors.initials: WY
authors.lastname: Liang
authors.forename: Jeng-Kae
authors.initials: JK
authors.lastname: Jiang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000097:blood; D018395:CA-19-9 Antigen / Q000097:blood; D002272:Carcinoembryonic Antigen / Q000097:blood; D015179:Colorectal Neoplasms / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness; D010534:Peritoneal Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000556:secondary*; D011446:Prospective Studies; D012307:Risk Factors
chemical_list: D014408:Biomarkers, Tumor; D018395:CA-19-9 Antigen; D002272:Carcinoembryonic Antigen