Sinukumar Snita, Kammar Praveen, Ray Mukurdipi, Shaikh Sakina, Patel Ankita, Rajan Firoz, Srinivasan Ayyappan, Damodaran Dileep, Mehta Sanket, Mahajan Vikas, Deo Suryanarayan V S, Bhatt Aditi
Dept. of Surgical Oncology, Jehangir Hospital, Pune, India.
Dept. of Surgical Oncology, Saifee Hospital, Mumbai, India.
Indian J Surg Oncol. 2023 Jun;14(Suppl 1):198-208. doi: 10.1007/s13193-023-01727-7. Epub 2023 Mar 9.
A previous report from the Indian HIPEC registry showed acceptable early survival and morbidity in patients undergoing cytoreductive surgery (CRS) + / - hyperthermic intraperitoneal chemotherapy (HIPEC). The goal of this retrospective study was to evaluate the long-term outcomes in these patients. Three hundred seventy-four patients treated from December 2010 to December 2016 and enrolled in the Indian HIPEC registry were included. All patients had completed 5 years from the date of surgery. The 1-, 3-, 5- and 7-year progression-free (PFS) and overall survival (OS) and factors affecting these were evaluated. The histology was epithelial ovarian cancer in 209 (46.5%), pseudomyxoma peritonei (PMP) in 65 (17.3%) and colorectal cancer in 46 (12.9%) patients. The peritoneal cancer index (PCI) was ≥ 15 in 160 (42.8%). A completeness of cytoreduction (CC) score of 0/1 resection was obtained in 83% (CC-0-65%; CC-1-18%). HIPEC was performed in 59.2%. At a median, follow-up of 77 months (6-120 months), 243 (64.9%) patients developed recurrence, and 236 (63%) died of any cause; 138 (36.9%) were lost to follow-up. The median OS was 56 months (95% CI 53.42-61.07), and the median PFS was 28 months (95% CI 37.5-44.4). The 1-, 3-, 5- and 7-year OS was 97.6%, 63%, 37.7% and 24% respectively. The 1-, 3-, 5- and 7-year PFS was 84.8%, 36.5%, 27.3% and 22% respectively. The use of HIPEC ( = 0.03) and PMP of appendiceal origin ( = 0.01) was independent predictors of a longer OS. CRS + / - /HIPEC may achieve long-term survival in patients with PM from different primary sites in the Indian scenario. More prospective studies are needed to confirm these findings and identify factors influencing long-term survival.
The online version contains supplementary material available at 10.1007/s13193-023-01727-7.
印度热灌注化疗登记处之前的一份报告显示,接受细胞减灭术(CRS)±热腹腔内化疗(HIPEC)的患者早期生存率和发病率可接受。这项回顾性研究的目的是评估这些患者的长期结局。纳入了2010年12月至2016年12月在印度热灌注化疗登记处登记的374例接受治疗的患者。所有患者自手术日期起已完成5年随访。评估了1年、3年、5年和7年的无进展生存期(PFS)和总生存期(OS)以及影响这些指标的因素。组织学类型为上皮性卵巢癌的有209例(46.5%),腹膜假黏液瘤(PMP)65例(17.3%),结直肠癌46例(12.9%)。腹膜癌指数(PCI)≥15的有160例(42.8%)。83%的患者实现了0/1级切除的细胞减灭完整性(CC)评分(CC-0为65%;CC-1为18%)。59.2%的患者接受了热灌注化疗。中位随访77个月(6 - 120个月)时,243例(64.9%)患者出现复发,236例(63%)因任何原因死亡;138例(36.9%)失访。中位总生存期为56个月(95%CI 53.42 - 61.07),中位无进展生存期为28个月(95%CI 37.5 - 44.4)。1年、3年、5年和7年的总生存率分别为97.6%、63%、37.7%和24%。1年、3年、5年和7年的无进展生存率分别为84.8%、36.5%、27.3%和22%。热灌注化疗的使用(P = 0.03)和阑尾起源的PMP(P = 0.01)是总生存期延长的独立预测因素。在印度的情况下,CRS±/HIPEC可能使不同原发部位的腹膜假黏液瘤患者获得长期生存。需要更多前瞻性研究来证实这些发现并确定影响长期生存的因素。
在线版本包含可在10.1007/s13193-023-01727-7获取的补充材料。