Adamina Michel, Warlaumont Maxime, Berger Martin D, Däster Silvio, Delaloye Raphaël, Digklia Antonia, Gloor Beat, Fritsch Ralph, Koeberle Dieter, Koessler Thibaud, Lehmann Kuno, Müller Phaedra, Peterli Ralph, Ris Frédéric, Steffen Thomas, Weisshaupt Christian Stefan, Hübner Martin
Klinik für Viszeral- und Thoraxchirurgie, Kantonsspital Winterthur, 8401 Winterthur, Switzerland.
Faculty of Medicine, University of Basel, 4056 Basel, Switzerland.
Cancers (Basel). 2022 Sep 1;14(17):4275. doi: 10.3390/cancers14174275.
Peritoneal cancer (PC) is a dire finding, yet in selected patients, long-term survival is possible. Complete cytoreductive surgery (CRS) together with combination immunochemotherapy is essential to achieve cure. Hyperthermic intraperitoneal chemotherapy (HIPEC) and pressurized intraperitoneal aerosol chemotherapy (PIPAC) are increasingly added to the multimodal treatment. The Swiss Peritoneal Cancer Group (SPCG) is an interdisciplinary group of expert clinicians. It has developed comprehensive treatment algorithms for patients with PC from pseudomyxoma peritonei, peritoneal mesothelioma, gastric, and colorectal origin. They include multimodal neoadjuvant treatment, surgical resection, and palliative care. The indication for and results of CRS HIPEC and PIPAC are discussed in light of the current literature. Institutional volume and clinical expertise required to achieve best outcomes are underlined, while inclusion of patients considered for CRS HIPEC and PIPAC in a clinical registry is strongly advised. The present recommendations are in line with current international guidelines and provide the first comprehensive treatment proposal for patients with PC including intraperitoneal chemotherapy. The SPCG comprehensive treatment algorithms provide evidence-based guidance for the multimodal care of patients with PC of gastrointestinal origin that were endorsed by all Swiss clinicians routinely involved in the multimodal care of these challenging patients.
腹膜癌(PC)是一个严峻的诊断结果,但在部分患者中,仍有可能实现长期生存。完整的细胞减灭术(CRS)联合免疫化疗对于实现治愈至关重要。热灌注化疗(HIPEC)和加压腹腔内气溶胶化疗(PIPAC)越来越多地被纳入多模式治疗中。瑞士腹膜癌研究组(SPCG)是一个由临床专家组成的跨学科团队。该团队已为源于腹膜假黏液瘤、腹膜间皮瘤、胃癌和结直肠癌的PC患者制定了全面的治疗方案。这些方案包括多模式新辅助治疗、手术切除和姑息治疗。本文结合当前文献讨论了CRS联合HIPEC和PIPAC的适应证及治疗结果。强调了实现最佳治疗效果所需的机构治疗量和临床专业知识,同时强烈建议将考虑接受CRS联合HIPEC和PIPAC治疗的患者纳入临床登记。本建议与当前国际指南一致,并为包括腹腔内化疗在内的PC患者提供了首个全面的治疗方案。SPCG的综合治疗方案为胃肠道来源的PC患者的多模式治疗提供了循证指导,得到了所有常规参与这些具有挑战性患者多模式治疗的瑞士临床医生的认可。