Department of Surgery, Hospital Moisès Broggi, Consorci Sanitari Integral, Barcelona, Spain.
Department of Clinical Epidemiology, Hospital Moisès Broggi, Consorci Sanitari Integral, Barcelona, Spain.
Clin Transl Oncol. 2023 Oct;25(10):2911-2921. doi: 10.1007/s12094-023-03155-z. Epub 2023 Apr 21.
Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS + HIPEC) treatment has classically presented a percentage of associated complications that have limited its expansion. The aim of this study is to describe the morbimortality results obtained from a referral center implemented with the support of a governmental health agency and directed by a surgical team experienced in CRS for Peritoneal Surface Malignancies (PSM).
Data from the Peritoneal Carcinomatosis Program of Catalonia (PCPC) prospective database, including patients who underwent CRS + HIPEC between September 2006 and January 2021, were analyzed.
A total of 1151 consecutive patients underwent 1321 CRS + HIPEC procedures. Colonic origin of peritoneal metastasis was the most frequent (47.3%). Median PCI was 7 and most patients had CC0-1 (96.1%). Multivisceral resection was performed in 44% of all patients, 57% required digestive anastomosis. Median hospital stay was 11 days (range 6-144 days). High-grade complications occurred in 20% of all patient, most of them surgical complications. Anastomotic leak occurred in 0.6% of all cases. The overall in-stay and 30-day mortality rate was 0.4%. The low-rate of complications and the high rate of complete CRS were achieved from the beginning of the PCPC. Median overall survival was 54.7 months, with a 5-year survival rate of 47.5%.
Implementation of a CRS + HIPEC referral program for the treatment of PSM with preferably an experienced surgical team enables acceptable rates of severe morbidity (20%) and mortality (< 1%).
细胞减灭术和腹腔热灌注化疗（CRS+HIPEC）的治疗方法经典地呈现出与并发症相关的比例，这限制了其扩展。本研究的目的是描述一个在政府卫生机构支持下建立的转诊中心，由一个在腹膜表面恶性肿瘤（PSM）的 CRS 方面经验丰富的外科团队指导，所获得的发病率和死亡率结果。
分析了加泰罗尼亚腹膜癌转移计划（PCPC）前瞻性数据库中 2006 年 9 月至 2021 年 1 月期间接受 CRS+HIPEC 的患者的数据。
共有 1151 例连续患者接受了 1321 例 CRS+HIPEC 手术。腹膜转移的结直肠来源最为常见（47.3%）。中位数 PCI 为 7，大多数患者为 CC0-1（96.1%）。所有患者中有 44%接受了多脏器切除术，57%需要进行消化吻合术。中位数住院时间为 11 天（范围 6-144 天）。所有患者中有 20%发生了高级别并发症，其中大多数为手术并发症。吻合口漏发生在所有病例的 0.6%。总住院和 30 天死亡率为 0.4%。从 PCPC 开始，并发症发生率低且完全 CRS 率高。中位总生存期为 54.7 个月，5 年生存率为 47.5%。
为治疗 PSM 实施 CRS+HIPEC 转诊计划，并由经验丰富的外科团队进行治疗，可以实现可接受的严重发病率（20%）和死亡率（<1%）。
