加拿大单中心腹部恶性肿瘤细胞减灭术和腹腔内热化疗经验。
A Canadian single-centre experience with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for abdominal malignancies.
机构信息
Department of Hematology-Oncology, Centre hospitalier de l'Université de Montréal, Montréal, Que. (Nassabein, Aubin, Ayoub, Tehfé); and the Department of Surgery, Centre hospitalier de l'Université de Montréal, Montréal, Que. (Younan, Loungarath, Mercier, Dagbert).
Department of Hematology-Oncology, Centre hospitalier de l'Université de Montréal, Montréal, Que. (Nassabein, Aubin, Ayoub, Tehfé); and the Department of Surgery, Centre hospitalier de l'Université de Montréal, Montréal, Que. (Younan, Loungarath, Mercier, Dagbert)
出版信息
Can J Surg. 2022 May 17;65(3):E342-E351. doi: 10.1503/cjs.004320. Print 2022 May-Jun.
BACKGROUND
Cytoreductive surgery in combination with hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) has recently shown promise for the treatment of patients with various types of peritoneal carcinomatosis (PC). However, it is an extensive procedure that is associated with a variety of morbidities. We evaluated the safety and clinical outcomes of CRS-HIPEC performed at our centre.
METHODS
Patients with abdominal malignancies who underwent CRS-HIPEC between February 2005 and December 2018 at the Centre hospitalier de l'Université de Montréal (CHUM) were retrospectively reviewed.
RESULTS
A total of 141 patients were identified (66 with appendiceal cancer, 62 with colorectal cancer, 10 with mesothelioma and 3 with small intestinal tumours). The median age was 55 years. Median overall survival (OS) was not reached for patients with appendiceal tumours; it was 38.3 months for colorectal cancers. Among patients with colorectal cancer, survival was significantly better for those who received intraperitoneal HIPEC with oxaliplatin (74.9 mo) compared with mitomycin C (29.1 mo) ( = 0.006). Complete cytoreductive surgery and low peritoneal carcinomatosis index were associated with the highest overall survival in patients with appendiceal tumours and those with colorectal tumours.
CONCLUSION
CRS-HIPEC can be performed with acceptable morbidity in patients with PC. These results validate the outcomes of previously reported trials, but further prospective trials are warranted to determine which patients will most benefit from the addition of HIPEC to CRS.
背景
细胞减灭术联合腹腔内热灌注化疗（CRS-HIPEC）最近显示出对治疗各种类型腹膜癌（PC）患者的潜力。然而，它是一种广泛的手术，与多种并发症相关。我们评估了我们中心进行的 CRS-HIPEC 的安全性和临床结果。
方法
回顾性分析 2005 年 2 月至 2018 年 12 月在蒙特利尔大学中心医院（CHUM）接受 CRS-HIPEC 的腹部恶性肿瘤患者。
结果
共确定了 141 名患者（阑尾癌 66 例，结直肠癌 62 例，间皮瘤 10 例，小肠肿瘤 3 例）。中位年龄为 55 岁。阑尾肿瘤患者的中位总生存期（OS）未达到；结直肠癌患者为 38.3 个月。在结直肠癌患者中，接受奥沙利铂腹腔 HIPEC 治疗的患者（74.9 个月）的生存率明显高于接受丝裂霉素 C（29.1 个月）的患者（=0.006）。完全细胞减灭术和低腹膜癌指数与阑尾肿瘤和结直肠肿瘤患者的总体生存率最高相关。
结论
CRS-HIPEC 可在 PC 患者中以可接受的发病率进行。这些结果验证了先前报告的试验结果，但需要进一步的前瞻性试验来确定哪些患者将从 CRS 加 HIPEC 中获益最大。
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