Spiliotis J, Vaxevanidou A, Halkia E, Hadjigeorgiou G, Datsis A
Department of Surgery, "Metaxa" Cancer Hospital, Piraeus, Greece.
J BUON. 2012 Jul-Sep;17(3):522-5.
Cytoreductive surgery (CS) and hyperthermic intraperitoneal chemotherapy (HIPEC) is the proper treatment for resectable peritoneal carcinomatosis (PC). The aim of this study was to evaluate the postoperative course and long-term outcome of repeat CS (reCS) plus repeat HIPEC (reHIPEC) in patients with recurrent disease, after primary CS plus primary HIPEC.
From 2004 to 2012 85 patients were subjected to primary CS + HIPEC. Fourteen of those patients developed recurrent PC and were subjected to reCS+reHIPEC during the same time period. Eligibility criteria included limited extent of the peritoneal disease, and interval of more than 12 months from the primary CS+HIPEC. The origins of the tumors were ovarian cancer (n=7) colorectal cancer (n=3), pseudomyxoma peritonei (n=3), and uterine sarcoma (n=1).
At second laparotomy, mean peritoneal cancer index (PCI) was 5.3 + 2.8. Among the 14 procedures, HIPEC was used in all patients. The postoperative mortality was 0% and grade 3-4 postoperative complications occurred in 4 patients. The overall 1-, 2- and 3- year overall survival rate was 90, 40 and 30%, respectively.
ReCS+reHIPEC is feasible and yields an accepted survival in highly selected patients.
细胞减灭术（CS）和腹腔热灌注化疗（HIPEC）是可切除性腹膜癌病（PC）的合适治疗方法。本研究的目的是评估在接受初次CS加初次HIPEC治疗后出现复发性疾病的患者中，重复CS（reCS）加重复HIPEC（reHIPEC）的术后病程及长期预后。
2004年至2012年期间，85例患者接受了初次CS + HIPEC治疗。其中14例患者出现复发性PC，并在同一时期接受了reCS+reHIPEC治疗。入选标准包括腹膜疾病范围有限，且距初次CS+HIPEC的间隔时间超过12个月。肿瘤起源包括卵巢癌（n = 7）、结直肠癌（n = 3）、腹膜假黏液瘤（n = 3）和子宫肉瘤（n = 1）。
在第二次剖腹手术时，平均腹膜癌指数（PCI）为5.3 + 2.8。在这14例手术中，所有患者均采用了HIPEC。术后死亡率为0%，4例患者出现3 - 4级术后并发症。1年、2年和3年的总生存率分别为90%、40%和30%。
reCS+reHIPEC在经过严格筛选的患者中是可行的，并且能带来可接受的生存率。
