Department of General, Visceral and Transplant Surgery, Comprehensive Cancer Center, University of Tübingen, Hoppe-Seyler-Strasse 3, 72076, Tübingen, Germany.
Langenbecks Arch Surg. 2013 Jun;398(5):745-9. doi: 10.1007/s00423-013-1065-6. Epub 2013 Mar 1.
Recurrent disease following complete cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) is a relevant clinical scenario. We aimed to determine risk factors for recurrence.
Prospectively collected data of patients enrolled in the Peritoneal Surface Malignancy Program at the University of Tübingen between 2005 and 2011 were retrospectively analyzed. All patients were treated by standardized CRS and HIPEC. Recurrence was defined either radiographically by CT, PET-CT scan, or reoperation.
Fifty-two patients received complete CRS (CC-0/CC-1) and HIPEC. Median time to recurrence was 229 days (103-1,028). Overall recurrence rate within follow-up was 48 %. Of patients with recurrent disease, 44 % experienced extraperitoneal systemic tumor spread. In multivariate analysis, grading of ≥ 3 was shown as an independent risk factor for recurrent disease, while a trend was observed for maximal tumor load in the upper abdominal region. Clinical parameters did not show an impact on recurrence.
Primary tumor grading seems to be an independent risk factor for recurrence following complete CRS and HIPEC in colorectal cancer-derived peritoneal surface malignancies.
完全细胞减灭术（CRS）和腹腔内热灌注化疗（HIPEC）后复发是一个相关的临床情况。我们旨在确定复发的危险因素。
回顾性分析了 2005 年至 2011 年间在图宾根大学腹膜表面恶性肿瘤计划中入组的患者的前瞻性收集数据。所有患者均接受标准化的 CRS 和 HIPEC 治疗。复发通过 CT、PET-CT 扫描或再次手术进行影像学诊断。
52 例患者接受了完全 CRS（CC-0/CC-1）和 HIPEC。复发的中位时间为 229 天（103-1028）。随访期间总体复发率为 48%。在复发的患者中，44%出现了腹膜外全身肿瘤扩散。多因素分析显示，≥3 级分级是复发的独立危险因素，而上腹部区域的最大肿瘤负荷呈趋势。临床参数对复发无影响。
在结直肠癌衍生的腹膜表面恶性肿瘤中，原发性肿瘤分级似乎是完全 CRS 和 HIPEC 后复发的独立危险因素。
