Department of Surgical Sciences, Section of Surgery, Uppsala University Hospital, Sweden.
Clin Colorectal Cancer. 2011 Jun;10(2):108-12. doi: 10.1016/j.clcc.2011.03.006. Epub 2011 Apr 22.
The purpose of this study was to present results on cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) of appendiceal adenocarcinoid (AAC) with peritoneal carcinomatosis (PC), to assess drug sensitivity of AAC, as compared with colorectal cancer (CRC), and to report any discordant histopathology.
Ten patients were treated with CRS and HIPEC. Treatment, drug sensitivity profiles, histopathology, and survival data were recorded and matched with potential prognostic indicators. Drug sensitivity was assessed with short-term fluorometric microculture cytotoxicity assay and compared with peritoneal metastases from CRC.
Patients with completeness of cytoreduction score (CC) ≤ 1 had better median survival (36.6 months) than those with CC > 1 (16.4 months). In the CC ≤ 1 group, 8 months elapsed between initial diagnosis and CRS with HIPEC compared with 22 months in the CC > 1 group. For standard drugs, tumor cells from AAC and CRC were equally sensitive; except for docetaxel, to which AAC was more sensitive than CRC.
The CC-score correlated with overall survival. Candidates for this type of treatment should be referred early for evaluation in order to reach a better CC score. Drugs used for CRC also seem adequate for treatment of AAC, although other drugs, eg, docetaxel, might be more active.
本研究旨在报告阑尾类癌伴腹膜转移患者行细胞减灭术（CRS）和腹腔热灌注化疗（HIPEC）的结果，评估阑尾类癌相对于结直肠癌（CRC）的药物敏感性，并报告任何不一致的组织病理学结果。
10 例患者接受了 CRS 和 HIPEC 治疗。记录了治疗、药物敏感性谱、组织病理学和生存数据，并与潜在的预后指标进行了匹配。采用短期荧光微培养细胞毒性测定法评估药物敏感性，并与 CRC 的腹膜转移进行比较。
完全细胞减灭评分（CC）≤1 的患者中位生存时间（36.6 个月）优于 CC>1 的患者（16.4 个月）。在 CC≤1 组中，从初始诊断到行 CRS 与 HIPEC 的时间间隔为 8 个月，而 CC>1 组为 22 个月。对于标准药物，阑尾类癌和 CRC 的肿瘤细胞对药物的敏感性相同；除了多西紫杉醇，阑尾类癌对其的敏感性高于 CRC。
CC 评分与总生存相关。应尽早为这类治疗的候选者转诊进行评估，以获得更好的 CC 评分。用于 CRC 的药物似乎也适用于 AAC 的治疗，尽管其他药物，如多西紫杉醇，可能更有效。
