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结肠和阑尾癌转移行肿瘤细胞减灭术及术中热灌注化疗后预后的预测因素:单中心经验

Factors Predictive of Outcomes after Cytoreductive Surgery and Heated Intraperitoneal Chemotherapy for Colon and Appendiceal Carcinomatosis: A Single-Institution Experience.

作者信息

Babcock Blake, Jabo Brice, Selleck Matthew, Reeves Mark, Garberoglio Carlos, Namm Jukes, Kazanjian Kevork, Senthil Maheswari

机构信息

Loma Linda University Cancer Center, Loma Linda, California, USA.

出版信息

Am Surg. 2018 Oct 1;84(10):1575-1579.

Abstract

Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS/HIPEC), although considered an acceptable treatment option in the management of selected patients with colon and appendiceal peritoneal carcinomatosis (PC), concerns about morbidity have limited its acceptance. Our objective was to evaluate the short- and long-term outcomes of CRS/HIPEC for appendix and colon PC performed at our institution and to elucidate factors predictive of patient outcomes. All patients who underwent CRS/HIPEC for appendix or colon PC from 2011 to 2017 were identified from our institution's prospective database. Postoperative outcomes, overall survival, and recurrence-free survival were assessed. Of 125 patients who underwent CRS/HIPEC during the study period, 45 patients were eligible (appendix n = 26; colon n = 19). The median postoperative length of stay was nine days (5-28 days). Grade III/IV complications occurred in 4/45 (8.8%) patients. There were no postoperative mortalities. Median DFS and overall survival have not yet been reached, in both the colon and appendix groups. As of the study conclusion date, 37/45 (82.2%) patients were alive with or without disease. Lymph node status was predictive of recurrence in appendix PC. In our experience, CRS/HIPEC can be safely performed with acceptable short- and long-term outcomes. Lymph node status is an important predictor of recurrence.

摘要

细胞减灭术和腹腔内热灌注化疗(CRS/HIPEC),尽管在部分结肠癌和阑尾腹膜转移癌(PC)患者的治疗中被视为一种可接受的治疗选择,但对其发病率的担忧限制了它的应用。我们的目的是评估在本机构进行的阑尾和结肠PC的CRS/HIPEC的短期和长期结果,并阐明预测患者预后的因素。从本机构的前瞻性数据库中识别出2011年至2017年期间接受阑尾或结肠PC的CRS/HIPEC治疗的所有患者。评估术后结果、总生存期和无复发生存期。在研究期间接受CRS/HIPEC的125例患者中,45例符合条件(阑尾26例;结肠19例)。术后中位住院时间为9天(5 - 28天)。4/45(8.8%)例患者发生Ⅲ/Ⅳ级并发症。无术后死亡病例。结肠组和阑尾组的中位无病生存期和总生存期均未达到。截至研究结束日期,45例患者中有37例(82.2%)存活,无论有无疾病。淋巴结状态可预测阑尾PC的复发。根据我们的经验,CRS/HIPEC可以安全地进行,短期和长期结果均可接受。淋巴结状态是复发的重要预测因素。

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