Department of Surgical Sciences, Section of Surgery, Uppsala University, Uppsala, Sweden.
Department of Molecular Medicin and Surgery, Karolinska Institutet, Stockholm, Sweden.
Cancer Med. 2019 Oct;8(14):6468-6475. doi: 10.1002/cam4.2436. Epub 2019 Sep 4.
The study aim was to report survival and morbidity of all patients in Sweden with peritoneal mesothelioma treated with cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) as well as investigate whether the survival has increased on a population level since this treatment was nationalized 2011. Study data were collected from the Swedish HIPEC registry and the Swedish National Cancer Registry. All patients with peritoneal mesothelioma scheduled for CRS/HIPEC treatment in Sweden January 2011 to March 2018 were retrieved from the Swedish HIPEC registry. Clinicopathological and survival data were collected. For population-level analysis, all patients with diffuse malignant peritoneal mesothelioma (DMPM) were identified from the Swedish National Cancer Registry and data were retrieved from two separate 5-year time periods: 1999-2003 and 2011-2015. Thirty-two patients were accepted for CRS/HIPEC. Four were open/close cases. Two-year survival rate was 84% or 59% when excluding borderline peritoneal mesotheliomas (n = 17). Median overall survival was not reached. Grade III-IV Clavien-Dindo events occurred in 22% with no mortality. From the national cancer registry, 102 DMPM cases were retrieved: 40 cases between 1999 and 2003, and 62 cases between 2011 and 2015 (corresponding to an increase from 0.9 to 1.24/million/year, P = .04). Six patients (10%) received CRS/HIPEC in the second period. Median OS increased between periods from 7 to 15 months and 5-year survival from 14% to 29% (P = .03). Peritoneal mesothelioma of both borderline and DMPM subtypes undergoing CRS/HIPEC have good long-term survival. The incidence of DMPM in Sweden has increased. Overall survival has increased alongside the introduction of CRS/HIPEC, which may be a contributing factor.
本研究旨在报告在瑞典接受细胞减灭术（CRS）和腹腔内热灌注化疗（HIPEC）治疗的所有腹膜间皮瘤患者的生存和发病率，并探讨自 2011 年该治疗方法被纳入国家医保以来，人群水平的生存率是否有所提高。研究数据来自瑞典 HIPEC 注册中心和瑞典国家癌症登记处。从瑞典 HIPEC 注册中心检索了 2011 年 1 月至 2018 年 3 月期间所有计划接受 CRS/HIPEC 治疗的腹膜间皮瘤患者。收集了临床病理和生存数据。为了进行人群水平分析，从瑞典国家癌症登记处确定了所有弥漫性恶性腹膜间皮瘤（DMPM）患者，并从两个单独的 5 年时间段检索了数据：1999-2003 年和 2011-2015 年。32 例患者接受了 CRS/HIPEC 治疗。4 例为开放/关闭病例。排除交界性腹膜间皮瘤（n=17）后，2 年生存率为 84%或 59%。中位总生存期未达到。22%的患者发生 III-IV 级 Clavien-Dindo 事件，无死亡。从国家癌症登记处检索到 102 例 DMPM 病例：40 例来自 1999 年至 2003 年，62 例来自 2011 年至 2015 年（相应发病率从 0.9 例/百万/年增加到 1.24 例/百万/年，P=0.04）。第二期有 6 例（10%）患者接受了 CRS/HIPEC 治疗。两个时期的中位 OS 从 7 个月增加到 15 个月，5 年生存率从 14%增加到 29%（P=0.03）。接受 CRS/HIPEC 治疗的交界性和 DMPM 亚型腹膜间皮瘤患者具有良好的长期生存。瑞典 DMPM 的发病率有所增加。随着 CRS/HIPEC 的引入，总体生存率有所提高，这可能是一个促成因素。
