Wang L, Cai J, Qin Q Y
Department of Colorectal Surgery, the Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou 510655, China.
Zhonghua Wai Ke Za Zhi. 2018 Aug 1;56(8):569-572. doi: 10.3760/cma.j.issn.0529-5815.2018.08.003.
Peritoneal metastasis is the second leading cause of death of colorectal cancer patients. Cytoreductive surgery (CRS) combined with hyperthermia intraperitoneal chemotherapy (HIPEC) is the primary method to treat peritoneal metastasis of colorectal cancer, though there remain some controversies. We reviewed current studies of colorectal peritoneal carcinomatosis (PC) and CRS+ HIPEC, and discussed some issues with regard to the scoring system for peritoneal metastasis, selection criteria for CRS+ HIPEC treatment, and the new drug application for colorectal PC. Peritoneal carcinomatosis index (PCI) is the most useful scoring system for peritoneal metastasis and CRS+ HIPEC is the primary treatment for colorectal PC. Patients with PCI<20 should receive thorough assessment on the feasibility of R0 or R1 resection and CRS+ HIPEC treatment. For patients with unresectable PC at the initial stage, active drug therapy should be adopted to achieve tumor regression, so that some of them would have the opportunity to receive CRS+ HIPEC treatment.
腹膜转移是结直肠癌患者的第二大死亡原因。细胞减灭术（CRS）联合腹腔内热灌注化疗（HIPEC）是治疗结直肠癌腹膜转移的主要方法，尽管仍存在一些争议。我们回顾了目前关于结直肠癌腹膜癌病（PC）和CRS+HIPEC的研究，并讨论了一些关于腹膜转移评分系统、CRS+HIPEC治疗选择标准以及结直肠癌PC新药应用的问题。腹膜癌病指数（PCI）是评估腹膜转移最有用的评分系统，CRS+HIPEC是结直肠癌PC的主要治疗方法。PCI<20的患者应全面评估R0或R1切除及CRS+HIPEC治疗的可行性。对于初始阶段不可切除的PC患者，应采用积极的药物治疗使肿瘤缩小，以便其中一些患者有机会接受CRS+HIPEC治疗。
