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接受腹腔热灌注化疗(HIPEC)治疗的结直肠癌腹膜转移患者的泌尿外科手术:发病率和生存分析

Urological procedures in patients with peritoneal carcinomatosis of colorectal cancer treated with HIPEC: morbidity and survival analysis.

作者信息

Braam Hidde J, van Oudheusden Thijs R, de Hingh Ignace H J T, Nienhuijs Simon W, Boerma Djamila, Wiezer Marinus J, van Ramshorst Bert

机构信息

Department of Surgery, St. Antonius Hospital, Nieuwegein, Netherlands

Department of Surgery, Catharina Hospital, Eindhoven, Netherlands.

出版信息

Anticancer Res. 2015 Jan;35(1):295-300.

Abstract

AIM

To investigate whether cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS+HIPEC) is a feasible and effective option for patients with urological involvement of peritoneal carcinomatosis from colorectal cancer (CRC-PC).

PATIENTS AND METHODS

The characteristics of patients with CRC-PC treated with CRS+HIPEC, with or without a urological procedure, between April 2005 and June 2013 in two tertiary Centres were analyzed.

RESULTS

Thirty-eight patients (14%) out of 267 CRC-PC patients treated with CRS+HIPEC had a urological procedure during cytoreduction. The median survival was not significantly different between patients with or without a urological procedure (26.9 versus 32.1 months, p=0.29). Severe complications occurred more in patients with a urological procedure (47% versus 20%, p<0.001). In patients with a urological procedure, the most frequent complications were gastrointestinal leakage (n=9) and intra-abdominal abscess formation (n=5).

CONCLUSION

Urological resections as a part of CRS+HIPEC in patients with peritoneal carcinomatosis of colorectal origin are feasible and effective. Severe complications are prevalent in these patients but survival is comparable to patients without involvement of the urinary system.

摘要

目的

探讨细胞减灭术联合腹腔热灌注化疗(CRS+HIPEC)对于结直肠癌腹膜转移(CRC-PC)伴泌尿系统受累患者是否为一种可行且有效的治疗选择。

患者与方法

分析了2005年4月至2013年6月期间在两家三级中心接受CRS+HIPEC治疗的CRC-PC患者的特征,这些患者接受或未接受泌尿系统手术。

结果

267例接受CRS+HIPEC治疗的CRC-PC患者中,38例(14%)在细胞减灭术中接受了泌尿系统手术。接受或未接受泌尿系统手术的患者中位生存期无显著差异(26.9个月对32.1个月,p=0.29)。接受泌尿系统手术的患者严重并发症发生率更高(47%对20%,p<0.001)。在接受泌尿系统手术的患者中,最常见的并发症是胃肠道漏(n=9)和腹腔内脓肿形成(n=5)。

结论

对于结直肠癌腹膜转移患者,泌尿系统切除术作为CRS+HIPEC的一部分是可行且有效的。这些患者中严重并发症很常见,但生存期与未累及泌尿系统的患者相当。

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