细胞减灭术加腹腔热灌注化疗可提高结直肠癌腹膜转移患者的生存率：来自中国中心的一项病例对照研究。
Cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy improves survival of patients with peritoneal carcinomatosis from colorectal cancer: a case-control study from a Chinese center.
机构信息
Department of Oncology, Zhongnan Hospital of Wuhan University, Hubei Cancer Clinical Study Center & Hubei Key Laboratory of Tumor Biological Behaviors, Wuhan, P.R. China.
出版信息
J Surg Oncol. 2014 Jun;109(7):730-9. doi: 10.1002/jso.23545. Epub 2013 Dec 27.
BACKGROUND
Advanced colorectal cancer (CRC) is prone to developing peritoneal carcinomatosis (PC). This case-control study was to compare the efficacy and safety of cytoreductive surgery (CRS) versus CRS plus hyperthermic intraperitoneal chemotherapy (HIPEC) in Chinese patients with CRC PC.
METHODS
The 62 consecutive PC patients were treated with CRS (Control group, n = 29) or CRS + HIPEC (Study group, n = 33). The primary end point was overall survival (OS), the secondary end points were perioperative safety profiles.
RESULTS
For the comparison of Control versus Study groups, the peritoneal cancer index (PCI) ≤20 was 13 (44.8%) versus 16 (48.5%) patients (P = 0.78), complete cytoreduction (CC0-1) was achieved in 9 (31.0%) versus 14 (42.4%) cases (P = 0.36). At the median OS was 8.5 (95% confidence interval [CI] 4.7-12.4) versus 13.7 (95% CI 10.0-16.5) months (P = 0.02), the 1-, 2-, and 3-year survival rates were 27.5% versus 63.6%, 12.0% versus 20.0%, and 0.0% versus 16.0%, respectively. Serious adverse events in postoperative 30 days were 9.4% versus 28.6% (P = 0.11). Multivariate analysis revealed that CRS + HIPEC, CC0-1, adjuvant chemotherapy ≥6 cycles were independent factors for OS benefit.
CONCLUSION
CRS + HIPEC could improve OS for CRC PC patients, with acceptable perioperative safety.
背景
晚期结直肠癌（CRC）易发生腹膜转移（PC）。本病例对照研究旨在比较细胞减灭术（CRS）与 CRS 联合腹腔热灌注化疗（HIPEC）在治疗中国 CRC PC 患者中的疗效和安全性。
方法
对 62 例 PC 患者进行 CRS（对照组，n=29）或 CRS+HIPEC（研究组，n=33）治疗。主要终点是总生存（OS），次要终点是围手术期安全性。
结果
与对照组相比，研究组患者的腹膜肿瘤指数（PCI）≤20 的患者为 13 例（44.8%）与 16 例（48.5%）（P=0.78），达到完全肿瘤减灭（CC0-1）的患者为 9 例（31.0%）与 14 例（42.4%）（P=0.36）。中位 OS 为 8.5（95%置信区间[CI] 4.7-12.4）与 13.7（95% CI 10.0-16.5）个月（P=0.02），1、2、3 年生存率分别为 27.5%与 63.6%、12.0%与 20.0%、0.0%与 16.0%。术后 30 天严重不良事件发生率为 9.4%与 28.6%（P=0.11）。多因素分析显示，CRS+HIPEC、CC0-1、辅助化疗≥6 周期是 OS 获益的独立因素。
结论
CRS+HIPEC 可提高 CRC PC 患者的 OS，且围手术期安全性可接受。
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