西班牙采用细胞减灭术（CRS）和腹腔内热灌注化疗（HIPEC）治疗腹膜表面恶性肿瘤：西班牙腹膜肿瘤外科小组国家登记处（REGECOP）的结果
Treatment of Peritoneal Surface Malignancies by Cytoreductive Surgery (CRS) and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) in Spain: Results of the National Registry of the Spanish Group of Peritoneal Oncologic Surgery (REGECOP).
作者信息
Manzanedo Israel, Pereira Fernando, Cascales-Campos Pedro, Muñoz-Casares Cristobal, Asensio Enrique, Torres-Melero Juan, Prada-Villaverde Arancha, Caravaca-García Ibán, Gutiérrez-Calvo Alberto, Vaqué Javier, Ortega Gloria, Titos-García Alberto, González-Sánchez Laura, Pérez-Viejo Estíbalitz, Serrano Ángel, Martínez-Torres Beatriz
机构信息
Peritoneal Carcinomatosis Unit, Department of General and Digestive Surgery, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain.
Department of Surgery, Rey Juan Carlos University (URJC), 28933 Madrid, Spain.
出版信息
J Clin Med. 2023 May 31;12(11):3774. doi: 10.3390/jcm12113774.
INTRODUCTION
Treatment of Peritoneal Surface Malignancies (PSM) with cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) has achieved results never seen before in these patients, which classically have a poor prognosis. The possibility of conducting clinical trials in these diseases is complicated, since some of them are rare, so the analysis of large databases provides very valuable scientific information. The aim of this study is to analyze the global results of the National Registry of the Spanish Group of Peritoneal Oncologic Surgery (REGECOP), whose objective is to register all patients scheduled for HIPEC nationwide.
METHODS
This is a retrospective analysis of the data recorded in the REGECOP from 36 Spanish hospitals from 2001 to 2021. There were 4159 surgical interventions in 3980 patients.
RESULTS
66% are women and 34% are men with a median age of 59 years (range 17-86). 41.5% of the patients were treated for Peritoneal Metastases (PM) of colorectal cancer (CRC); 32.4% were women with ovarian cancer (OC) with PM; 12.8% were treated for pseudomyxoma peritonei (PMP); 6.2% had PM from gastric cancer (GC); 4.9% had PM of non-conventional origin; and, finally, 2.1% of cases were patients diagnosed with peritoneal mesothelioma. The median Peritoneal Cancer Index (PCI) was 9 (0-39), and complete cytoreduction was achieved in 81.7% of the procedures. Severe morbidity (Dindo-Clavien grade III-IV) was observed in 17.7% of surgeries, with 2.1% mortality. Median hospital stay was 11 days (0-259). Median overall survival (OS) was 41 months for CRC patients, 55 months for women with OC, was not reached in PMP patients, was 14 months for GC patients, and 66 months in mesothelioma patients.
CONCLUSIONS
large databases provide extremely useful data. CRS with HIPEC in referral centers is a safe treatment with encouraging oncologic results in PSM.
引言
采用细胞减灭术（CRS）和腹腔热灌注化疗（HIPEC）治疗腹膜表面恶性肿瘤（PSM）已取得了这类患者前所未有的治疗效果，这类患者传统上预后较差。在这些疾病中开展临床试验存在复杂性，因为其中一些疾病较为罕见，所以对大型数据库的分析能提供非常有价值的科学信息。本研究的目的是分析西班牙腹膜肿瘤外科组国家登记处（REGECOP）的整体结果，其目标是登记全国所有计划接受HIPEC治疗的患者。
方法
这是一项对2001年至2021年期间来自36家西班牙医院记录在REGECOP中的数据进行的回顾性分析。3980例患者共进行了4159次手术干预。
结果
66%为女性，34%为男性，中位年龄为59岁（范围17 - 86岁）。41.5%的患者因结直肠癌（CRC）腹膜转移（PM）接受治疗；32.4%为患有PM的卵巢癌（OC）女性患者；12.8%的患者因腹膜假黏液瘤（PMP）接受治疗；6.2%的患者因胃癌（GC）PM接受治疗；4.9%的患者PM来源不明；最后，2.1%的病例为被诊断为腹膜间皮瘤的患者。中位腹膜癌指数（PCI）为9（0 - 39），81.7%的手术实现了完全细胞减灭。17.7%的手术观察到严重并发症（Dindo-Clavien III - IV级），死亡率为2.1%。中位住院时间为11天（0 - 259天）。CRC患者的中位总生存期（OS）为41个月，OC女性患者为55个月，PMP患者未达到，GC患者为14个月，间皮瘤患者为66个月。
结论
大型数据库提供了极其有用的数据。在转诊中心采用CRS联合HIPEC治疗PSM是一种安全的治疗方法，肿瘤学结果令人鼓舞。
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