Spiliotis John, Kalles Vasileios, Kyriazanos Ioannis, Terra Alexios, Prodromidou Anastasia, Raptis Apostolos, Kopanakis Nikolaos, Christopoulou Athina
Department of Peritoneal Surface Oncology, Athens Medical Centre, Athens, Attica, Greece.
Department of Surgery, Naval Hospital of Athens, Deinokratous 70, Athens, Greece.
Pleura Peritoneum. 2019 Oct 30;4(4):20190018. doi: 10.1515/pp-2019-0018. eCollection 2019 Dec 1.
Combining cytoreductive surgery (CRS) with Hyperthermic IntraPeritoneal Chemotherapy (HIPEC) can benefit patients with peritoneal metastasis from colorectal cancer. The present study evaluates the small bowel subset of the Peritoneal Cancer Index (Small-Bowel-PCI score (SB-PCI), min-max 0-12) as a prognostic factor in such patients.
We retrospectively analyzed patients that underwent CRS and HIPEC for recurrent colorectal cancer with peritoneal metastasis. Patient characteristics, procedure details, and clinical outcomes were evaluated.
Eighty patients were included. The mean intraoperative PCI-score was 16.8, with a mean SB-PCI score of 5.9. CC0/1 was achieved in 62/80 patients. The mean follow-up period was 26.3 months. Univariate regression analysis showed that the ECOG status, the presence of severe complications, the HIPEC regimen (oxaliplatin vs. mitomycin-C), the PCI score, the SB-PCI score and the completeness of cytoreduction correlated significantly with overall survival. In multivariate analysis, the SB-PCI and CC score were identified as independent prognostic factors of survival. When the SB-PCI was stratified in three groups (0-4, 5-8 and 9-12), Kaplan-Meier curve analysis showed significant difference in survival (p<0.001).
The SB-PCI correlates with overall survival in patients with peritoneal metastases secondary to colorectal cancer in this retrospective cohort. Its use should be validated in prospective patient series.
细胞减灭术（CRS）联合腹腔热灌注化疗（HIPEC）可使结直肠癌腹膜转移患者获益。本研究评估腹膜癌指数的小肠亚组（小肠PCI评分（SB-PCI），范围0 - 12）作为此类患者的预后因素。
我们回顾性分析了因复发性结直肠癌伴腹膜转移而接受CRS和HIPEC治疗的患者。评估了患者特征、手术细节和临床结局。
纳入80例患者。术中PCI评分均值为16.8，SB-PCI评分均值为5.9。80例患者中有62例达到CC0/1。平均随访期为26.3个月。单因素回归分析显示，ECOG状态、严重并发症的存在、HIPEC方案（奥沙利铂与丝裂霉素-C）、PCI评分、SB-PCI评分和细胞减灭的完整性与总生存期显著相关。多因素分析中，SB-PCI和CC评分被确定为生存的独立预后因素。当将SB-PCI分为三组（0 - 4、5 - 8和9 - 12）时，Kaplan-Meier曲线分析显示生存存在显著差异（p<0.001）。
在这个回顾性队列中，SB-PCI与结直肠癌继发腹膜转移患者的总生存期相关。其应用应在前瞻性患者系列中得到验证。
