Tom Baker Cancer Center, Calgary, Alberta, Canada.
Vancouver General Hospital, Vancouver, British Columbia, Canada.
J Surg Oncol. 2023 Sep;128(4):595-603. doi: 10.1002/jso.27301. Epub 2023 May 30.
Peritoneal mesothelioma (PM) is a rare malignancy originating from the peritoneal lining. Cytoreductive surgery (CRS) and heated intraperitoneal chemotherapy (HIPEC) is the standard-of-care for patients with isolated PM. Due to a paucity of prospective data there are several different HIPEC protocols. The aims of this study are to describe the CRS and HIPEC protocols for PM and patient outcomes across Canada.
A multicenter retrospective study was performed on patients diagnosed and treated for PM with CRS and HIPEC in four major peritoneal disease centers in Canada between 2000 and 2021. Data on patient characteristics, treatment patterns, postoperative morbidity, recurrence, and survival were collected.
A total of 72 patients were identified. Mean age was 52 years (17-75) and 37.5% were male. Epithelioid (70.1%) and multicystic (13%) mesothelioma were the most common subtypes. Twenty-one patients (30%) were treated with neoadjuvant chemotherapy. CRS and HIPEC was performed in 64 patients (91.4%). Of these, the mean PCI was 22 (2-39) and cisplatin+doxorubicin was the most common HIPEC regimen (n = 33, 51.6%). A semi-closed coliseum technique was used in 68.8% of HIPECs and the mean duration of surgery was 486 min (90-1052). Clavien-Dindo III or IV complications occurred in 12 patients (16.9%). With a median follow-up of 24 months (0.2-104.4), we found a 5-year overall survival of 61% and a 5-year recurrence-free survival of 35%.
CRS and HIPEC is a safe and effective treatment modality for well-selected patients with PM, with some achieving prolonged survival.
腹膜间皮瘤（PM）是一种罕见的恶性肿瘤，起源于腹膜衬里。细胞减灭术（CRS）和腹腔热灌注化疗（HIPEC）是治疗孤立性 PM 患者的标准治疗方法。由于缺乏前瞻性数据，因此存在几种不同的 HIPEC 方案。本研究的目的是描述加拿大四个主要腹膜疾病中心在 2000 年至 2021 年间对接受 CRS 和 HIPEC 治疗的 PM 患者的 CRS 和 HIPEC 方案以及患者结局。
对加拿大四个主要腹膜疾病中心在 2000 年至 2021 年间接受 CRS 和 HIPEC 治疗的 PM 患者进行了多中心回顾性研究。收集了患者特征、治疗模式、术后发病率、复发和生存的数据。
共确定了 72 名患者。平均年龄为 52 岁（17-75 岁），37.5%为男性。上皮样（70.1%）和多囊性（13%）间皮瘤是最常见的亚型。21 名患者（30%）接受了新辅助化疗。64 名患者（91.4%）接受了 CRS 和 HIPEC 治疗。其中，平均 PCI 为 22（2-39），顺铂+多柔比星是最常见的 HIPEC 方案（n=33，51.6%）。半闭式结肠间室技术在 68.8%的 HIPEC 中使用，手术平均持续时间为 486 分钟（90-1052 分钟）。Clavien-Dindo III 或 IV 级并发症发生在 12 名患者（16.9%）中。中位随访 24 个月（0.2-104.4 个月），我们发现 5 年总生存率为 61%，5 年无复发生存率为 35%。
CRS 和 HIPEC 是一种安全有效的治疗方法，适用于精心选择的 PM 患者，一些患者获得了延长的生存时间。
