Department of Surgery, St George Hospital, Sydney, NSW, Australia; St George & Sutherland Clinical School, University of New South Wales, Sydney, Australia.
Department of Surgery, St George Hospital, Sydney, NSW, Australia; St George & Sutherland Clinical School, University of New South Wales, Sydney, Australia.
Eur J Surg Oncol. 2021 Jun;47(6):1406-1410. doi: 10.1016/j.ejso.2020.11.138. Epub 2020 Nov 27.
Higher Peritoneal Cancer Index (PCI) requires more extensive surgery and maybe associated with more limited outcomes. The aim of this study in a high-volume centre in Australia was to analyse the outcomes in PCI 39 patients regarding short and long term outcomes in appendiceal tumours.
A retrospective analysis of prospectively maintained database of patients that underwent primary cytoreductive surgery (CRS) + hyperthermic intraperitoneal chemotherapy (HIPEC) with PCI 39 at St George Hospital, Sydney from 1996 to 2018. Patients with appendiceal tumours (inclusive of high and low grade) were analysed. Factors contributing to high grade (III/IV Clavien-Dindo) morbidity and mortality were assessed.
Of the 1201 patients in the database, 58 patients had a PCI 39 from appendix tumours at their first operation. The overall survival rate at 1, 3 and 5 year was 91.2%, 79.5% and 62.9% respectively. The median survival was 87.2 months (96% CI 51.8-NR). The rate of major morbidity was 71%. The postoperative mortality incidence was 1.7%. The median hospital length of stay was 34 days (IQR:27-54 days).
In an experienced centre CRS + HIPEC is safe in selected patients with PCI 39. Despite the high morbidity, the overall survival for appendiceal tumours appear considerably better than debulking surgery.
较高的腹膜肿瘤指数（PCI）需要更广泛的手术，可能与更有限的结果相关。本研究在澳大利亚一家高容量中心的目的是分析 PCI 39 患者在阑尾肿瘤方面的短期和长期结果。
对 1996 年至 2018 年期间在悉尼圣乔治医院接受初次细胞减灭术（CRS）+腹腔内热化疗（HIPEC）且 PCI 39 的前瞻性数据库进行回顾性分析。分析阑尾肿瘤（包括高级别和低级别）患者。评估导致高级别（III/IV Clavien-Dindo）发病率和死亡率的因素。
在数据库的 1201 名患者中，有 58 名患者在首次手术时患有源自阑尾的 PCI 39 肿瘤。1、3 和 5 年的总生存率分别为 91.2%、79.5%和 62.9%。中位生存期为 87.2 个月（96%CI 51.8-NR）。主要发病率为 71%。术后死亡率为 1.7%。中位住院时间为 34 天（IQR：27-54 天）。
在有经验的中心，CRS+HIPEC 对 PCI 39 选定患者是安全的。尽管发病率较高，但阑尾肿瘤的总生存率明显好于减瘤手术。
