Cavaliere F, De Simone M, Virzì S, Deraco M, Rossi C R, Garofalo A, Di Filippo F, Giannarelli D, Vaira M, Valle M, Pilati P, Perri P, La Pinta M, Monsellato I, Guadagni F
Department of Surgery, San Giovanni Hospital, Via dell'Amba Aradam 9, 00184 Rome, Italy.
Eur J Surg Oncol. 2011 Feb;37(2):148-54. doi: 10.1016/j.ejso.2010.10.014. Epub 2010 Nov 18.
The present study was specifically designed to assess the major clinical and pathological variables of patients with colorectal peritoneal carcinomatosis in order to investigate whether currently used criteria appropriately select candidates for peritonectomy procedures (cytoreductive surgery) combined with hyperthermic intraperitoneal chemotherapy (HIPEC).
Preoperative, operative and follow-up data on 146 consecutive patients presenting with peritoneal carcinomatosis of colorectal origin and treated by surgical cytoreduction combined with HIPEC in 5 Italian Hospital and University Centers were prospectively entered in a common database. Univariate and multivariate analyses were used to assess the prognostic value of clinical and pathologic factors.
Over a minimum 24-month follow-up, the overall morbidity rate was 27.4% (mortality rate: 2.7%) and was directly related to the extent of surgery. Peritoneal cancer index (PCI), unfavorable peritoneal sites, synchronous or previously resected liver metastasis and the completeness of cytoreduction, all emerged as independent prognostic factors correlated with survival.
Until research provides more effective criteria for selecting patients based upon the biomolecular features of carcinomatosis, patients should be selected according to the existing independent prognostic variables.
本研究旨在专门评估结直肠腹膜癌患者的主要临床和病理变量，以调查目前使用的标准是否能适当筛选出适合接受腹膜切除术（细胞减灭术）联合腹腔内热灌注化疗（HIPEC）的患者。
前瞻性地将意大利5家医院和大学中心连续收治的146例结直肠源性腹膜癌患者的术前、手术及随访数据录入一个通用数据库，这些患者均接受了手术细胞减灭术联合HIPEC治疗。采用单因素和多因素分析评估临床和病理因素的预后价值。
在至少24个月的随访期内，总体发病率为27.4%（死亡率：2.7%），且与手术范围直接相关。腹膜癌指数（PCI）、不利的腹膜部位、同时性或既往切除的肝转移以及细胞减灭的彻底性，均作为与生存相关的独立预后因素出现。
在研究基于癌病生物分子特征提供更有效筛选患者的标准之前，应根据现有的独立预后变量来选择患者。
