Department of Surgical Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia.
Sir Peter MacCallum Dept. of Oncology, University of Melbourne, Parkville, VIC, 3010, Australia.
J Gastrointest Surg. 2020 Sep;24(9):2104-2112. doi: 10.1007/s11605-019-04447-y. Epub 2019 Nov 19.
Cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) can offer selected patients with colorectal peritoneal metastases (CRPM) a favorable long-term survival. While cytoreductive techniques are standardized, there remains great variability in HIPEC drugs with mitomycin C or oxaliplatin use based largely on institute preference. In this study, we compared outcomes based on mitomycin C or oxaliplatin use after complete cytoreduction.
This is a retrospective analysis over a 7-year period of all patients undergoing complete cytoreduction with HIPEC.
Seventy-eight patients underwent complete cytoreduction with HIPEC during this time. Forty-six patients received oxaliplatin as HIPEC, and 32 received mitomycin C. There was no difference in patient characteristics, resections, or major morbidity between the two groups. Superficial wound infections were higher in the mitomycin C group (37.5% v 15.2%, p = 0.02). Median overall and disease-free survival for the entire cohort was 40 and 14 months, respectively. There was no difference in overall survival or disease-free survival between the two HIPEC groups (HR 0.50, 95% CI 0.11-2.28).
Complete cytoreduction and HIPEC can offer selected patients a favorable survival. The choice of mitomycin C or oxaliplatin for HIPEC had no influence on survival. Prospective studies are needed to explore this important issue.
细胞减灭术（CRS）联合腹腔热灌注化疗（HIPEC）可为特定的结直肠腹膜转移（CRPM）患者提供有利的长期生存。虽然细胞减灭技术已经标准化，但 HIPEC 药物仍存在很大的变异性，其中以丝裂霉素 C 或奥沙利铂的使用为主，这主要取决于机构的偏好。在这项研究中，我们比较了完全细胞减灭术后使用丝裂霉素 C 或奥沙利铂的结果。
这是一项回顾性分析，对 7 年内所有接受完全细胞减灭术联合 HIPEC 的患者进行分析。
在此期间，78 例患者接受了完全细胞减灭术联合 HIPEC。46 例患者接受奥沙利铂作为 HIPEC，32 例患者接受丝裂霉素 C。两组患者的特征、切除范围或主要发病率无差异。丝裂霉素 C 组浅表伤口感染发生率较高（37.5%比 15.2%，p=0.02）。整个队列的中位总生存期和无病生存期分别为 40 个月和 14 个月。两组 HIPEC 患者的总生存期或无病生存期无差异（HR 0.50，95%CI 0.11-2.28）。
完全细胞减灭术联合 HIPEC 可为选定的患者提供有利的生存。HIPEC 中选择丝裂霉素 C 或奥沙利铂对生存没有影响。需要前瞻性研究来探讨这一重要问题。
