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Peritoneal Involvement in Stage II Colon Cancer

A.M. Lennon MB, MRCPI, H.E. Mulcahy MD, MRCPI, J.M.P. Hyland MCh, FRCS, FRCSI, C. Lowry MB, A. White RGN, RN, DipONC, D. Fennelly MD, FRCPI, J.J. Murphy FRCS, FRCSI, D.P. O’Donoghue MD, FRCPI, FRCP, K. Sheahan MB, BSc, FRCPI, FCAP, FRCPath
DOI: http://dx.doi.org/10.1309/J6BDTWM2M792TN2V 108-113 First published online: 1 January 2003


A pathologist (K.S.) reviewed histologic slides for peritoneal involvement by tumor cells for 118 patients with stage II colon cancer. Patients were followed up for a median of 6 years.

Tumor cells were found free in the peritoneal space in 16 cases (13.6%). The presence of cancer cells free in the peritoneal space was associated with lymphovascular invasion (P = .001) and neural invasion (P < .001). The overall 5-year survival was 80% in the patient population, but was 39% and 86% for those with and without tumor cells free in the peritoneal space, respectively (P < .0001). Multivariate analysis confirmed that free tumor cells within the peritoneal space (P < .0001) and lymphovascular invasion (P = .007) were related independently to outcome.

Peritoneal involvement with tumor cells free in the peritoneal space in stage II colon cancer is a powerful indicator of outcome; patients have a survival similar to that for patients with stage III disease.

Key Words:
  • Colorectal cancer
  • Peritoneum
  • Local peritoneal involvement
  • Prognosis
  • Clinicopathologic staging
  • Lymph node–negative
  • Dukes B
  • Stage II
  • Survival
  • TNM, T4