Yurttas Can, Löffler Markus W, Königsrainer Alfred, Horvath Philipp
Klinik für Allgemeine, Viszeral- und Transplantationschirurgie, Universitätsklinikum Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Deutschland.
Partnerstandort Tübingen, Deutsches Konsortium für Translationale Krebsforschung (DKTK) am Deutschen Krebsforschungszentrum (DKFZ), Tübingen, Deutschland.
Chirurgie (Heidelb). 2022 Dec;93(12):1126-1132. doi: 10.1007/s00104-022-01694-9. Epub 2022 Aug 20.
Cytoreductive surgery, often in combination with hyperthermic intraperitoneal chemotherapy (HIPEC), has been instrumental in improving the survival of patients with peritoneal metastases from colorectal cancer. Recent studies have highlighted the benefits of complete cytoreduction, while the role of the HIPEC treatment remains unclear. An oxaliplatin-based HIPEC over 30 min could not achieve any clear benefits in studies on colorectal cancer, neither in the therapeutic nor in the prophylactic setting, but caused relevant side effects and increased the morbidity. The negative results of these studies with respect to oxaliplatin-based HIPEC require critical appraisal; however, they should by no means be regarded as a general setback for surgical treatment of peritoneal metastases and be misunderstood as a general failure of this treatment. While HIPEC after complete surgical cytoreduction of peritoneal metastases from colorectal cancer requires further research, cytoreductive surgery should still be regarded as a highly effective treatment for suitable patients with limited abdominal tumor dissemination.
细胞减灭术通常与腹腔内热灌注化疗（HIPEC）联合应用，对提高结直肠癌腹膜转移患者的生存率起到了重要作用。近期研究强调了完全细胞减灭的益处，而HIPEC治疗的作用仍不明确。在结直肠癌研究中，超过30分钟的基于奥沙利铂的HIPEC在治疗或预防方面均未取得明显益处，反而导致了相关副作用并增加了发病率。这些关于基于奥沙利铂的HIPEC的研究负面结果需要进行批判性评估；然而，绝不应将其视为腹膜转移手术治疗的总体挫折，也不应误解为这种治疗的全面失败。虽然结直肠癌腹膜转移完全手术细胞减灭术后的HIPEC仍需进一步研究，但对于腹部肿瘤播散有限的合适患者，细胞减灭术仍应被视为一种高效治疗方法。
