Department of Surgical Oncology, Erasmus Medical Center, P.O. Box 2040, 3000 CA, Rotterdam, the Netherlands.
Department of Surgical Oncology, Erasmus Medical Center, P.O. Box 2040, 3000 CA, Rotterdam, the Netherlands.
Eur J Surg Oncol. 2019 Mar;45(3):383-388. doi: 10.1016/j.ejso.2018.10.545. Epub 2018 Nov 2.
Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) is a well-established curative treatment for patients with peritoneal carcinomatosis (PC) from colorectal cancer (CRC) and pseudomyxoma peritonei (PMP). The study's aim was to present a single center's initial experience with CRS and HIPEC and report the postoperative morbidity in elderly patients.
A retrospective observational study was conducted of all patients with peritoneally disseminated colorectal cancer or pseudomyxoma peritonei undergoing CRS and HIPEC between March 2014 and March 2017. Patient characteristics and the peri- and postoperative course were reviewed. Elderly patients were defined as those aged ≥ 65 years. Postoperative complications were classified according to the Serious Adverse Event (SAE) grading system.
122 patients undergoing CRS and HIPEC were split into two groups based on age (< 65 years versus ≥ 65 years) at the time of surgery. Both groups were comparable for ASA score, Peritoneal Cancer Index (PCI), procedure time and blood loss. Serious Adverse Event (SAE) grade > 3 morbidity was 26.7% in the elderly group as opposed to 10.4% in the younger group (p = 0.034). Both univariate and multivariate logistic regression analysis demonstrated that age was a significant risk factor (OR = 3.2, 95% CI 1.1-9.4, p = 0.033) for severe postoperative morbidity (SAE > 3).
This retrospective study showed advanced age to be a significant risk factor for SAE > 3, after undergoing CRS and HIPEC. The initial institutional experience resembles previously published literature in terms of severe postoperative morbidity in elderly patients.
细胞减灭术（CRS）和腹腔内热灌注化疗（HIPEC）是一种成熟的治疗方法，可用于治疗结直肠癌（CRC）和假黏液瘤腹膜转移（PMP）患者的腹膜癌（PC）。本研究旨在介绍一家中心在 CRS 和 HIPEC 方面的初步经验，并报告老年患者的术后发病率。
对 2014 年 3 月至 2017 年 3 月期间接受 CRS 和 HIPEC 的所有腹膜播散性结直肠癌或假黏液瘤患者进行回顾性观察性研究。回顾了患者特征和围手术期过程。老年患者定义为年龄≥65 岁。根据严重不良事件（SAE）分级系统对术后并发症进行分类。
根据手术时的年龄（<65 岁与≥65 岁），将 122 例接受 CRS 和 HIPEC 的患者分为两组。两组的 ASA 评分、腹膜癌指数（PCI）、手术时间和失血量均相似。老年组严重不良事件（SAE）>3 级发病率为 26.7%，而年轻组为 10.4%（p=0.034）。单因素和多因素逻辑回归分析表明，年龄是术后严重发病率（SAE>3）的一个显著危险因素（OR=3.2，95%CI 1.1-9.4，p=0.033）。
这项回顾性研究表明，在接受 CRS 和 HIPEC 后，年龄是 SAE>3 的一个显著危险因素。该机构的初步经验与之前发表的文献相似，即老年患者术后严重发病率较高。
