Department of Surgery, Campus Virchow-Klinikum and Charité Campus Mitte, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.
Department of General and Visceral Surgery, Barmherzige Brueder Hospital Regensburg, Regensburg, Germany.
Gastric Cancer. 2020 Jan;23(1):11-22. doi: 10.1007/s10120-019-00978-0. Epub 2019 Jun 21.
Patients with peritoneal metastases of gastric cancer have a poor prognosis with a median survival of 7 months. A benefit of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) could be shown in several selected patient cohorts but remains controversial. The aim of this study was, to reflect the results of a national German HIPEC registry initiated by the German Society of General and Visceral Surgery (DGAV).
The DGAV HIPEC registry StuDoQ|Peritoneum documents patients with peritoneal malignancy contributed from 52 hospitals. All consecutive documented patients from 2011 until 2016 (n = 3078) were treated with CRS and HIPEC and were analysed. A total of 315 (10%) suffered from gastric cancer and were analysed.
A complete data set of 235 patients was available for this study, including 113 male (48.1%) and 122 female (51.9%) patients with a median age of 53.4 years (SD ± 11.9). The median PCI was 8.0 (range 1-30). A complete cytoreduction was achieved in 121 patients (71.6%). Postoperative complications (Clavien-Dindo grades 3-4) occurred in 40 patients (17%). The median overall survival (OS) time was 13 months. The 5-year survival rate was 6%. According to the PCI from 0-6 (n = 74); 7-15 (n = 70) and 16-39 (n = 24) the median OS differs significantly (18 months vs. 12 months vs. 5 months; p = 0.002).
CRS and HIPEC in selected patients with gastric cancer and peritoneal spread can improve survival when they are treated in centers. An accurate staging and patient selection are of major importance to achieve long-term survival.
患有胃癌腹膜转移的患者预后较差，中位生存期为 7 个月。细胞减灭术（CRS）和腹腔热灌注化疗（HIPEC）在一些选定的患者群体中显示出获益，但仍存在争议。本研究旨在反映德国普通和内脏外科协会（DGAV）发起的德国 HIPEC 注册研究的结果。
DGAV HIPEC 注册研究 StuDoQ|Peritoneum 记录了来自 52 家医院的腹膜恶性肿瘤患者。对 2011 年至 2016 年期间（n=3078）接受 CRS 和 HIPEC 治疗的所有连续记录患者进行了分析。共有 315 例（10%）患有胃癌并进行了分析。
本研究共纳入 235 例患者的完整数据集，包括 113 例男性（48.1%）和 122 例女性（51.9%），中位年龄为 53.4 岁（标准差±11.9）。中位 PCI 为 8.0（范围 1-30）。121 例患者（71.6%）实现了完全肿瘤减灭。40 例患者（17%）发生术后并发症（Clavien-Dindo 分级 3-4）。中位总生存期（OS）为 13 个月。5 年生存率为 6%。根据 PCI 评分（0-6[n=74]、7-15[n=70]和 16-39[n=24]），中位 OS 差异有统计学意义（18 个月比 12 个月比 5 个月；p=0.002）。
在有腹膜转移的胃癌患者中，在中心接受 CRS 和 HIPEC 治疗可以提高生存。准确的分期和患者选择对于实现长期生存至关重要。
