Jäger Tarkan, Schredl Philipp, Neureiter Daniel, Presl Jaroslav, Tschann Peter, Königsrainer Ingmar, Pascher Andreas, Emmanuel Klaus, Regenbogen Stephan, Ramspott Jan Philipp
Department of Surgery, Paracelsus Medical University Salzburg, 5020 Salzburg, Austria.
Institute of Pathology, Paracelsus Medical University Salzburg, 5020 Salzburg, Austria.
Cancers (Basel). 2023 Jun 10;15(12):3134. doi: 10.3390/cancers15123134.
(1) Background: Peritoneal metastasized colorectal cancer is associated with a worse prognosis. The combination of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) showed promising results in selected patients, but standardization is lacking so far. We present the first tool enabling standardized peritoneal surface area (PSA) quantification in patients undergoing CRS and HIPEC: The SAlzburg PEritoneal SUrface CAlculator (SAPESUCA). (2) Methods: SAPESUCA was programmed using the R-Shiny framework. The application was validated in 23 consecutive colon cancer patients who received 27 closed oxaliplatin-based HIPECs between 2016 and 2020. The programming algorithm incorporates the patient's body surface area and its correlated peritoneal surface area (PSA) based on the 13 Peritoneal Cancer Index (PCI) regions. (3) Results: Patients' median age was 56 years. Median PCI was 9. SAPESUCA revealed a mean PSA of 18,613 cm ± 1951 of all patients before compared to 13,681 cm ± 2866 after CRS. The Central PCI region revealed the highest mean peritonectomy extent (1517 cm ± 737). The peritonectomy extent correlated significantly with PCI score and postoperative morbidity. The simulated mean oxaliplatin dose differed significantly before and after CRS (558 mg/m ± 58.4 vs. 409 mg/m ± 86.1; < 0.0001). (4) Conclusion: SAPESUCA is the first free web-based app for standardized determination of the resected and remaining PSA after CRS. The tool enables chemotherapeutic dose adjustment to the remaining PSA.
(1) 背景：腹膜转移结直肠癌预后较差。细胞减灭术（CRS）与腹腔热灌注化疗（HIPEC）联合应用在部分患者中显示出良好效果，但目前仍缺乏标准化方案。我们推出了首个可对接受CRS和HIPEC治疗的患者进行标准化腹膜表面积（PSA）定量的工具：萨尔茨堡腹膜表面计算器（SAPESUCA）。(2) 方法：使用R-Shiny框架对SAPESUCA进行编程。该应用程序在2016年至2020年间连续接受27次基于奥沙利铂的封闭性HIPEC治疗的23例结肠癌患者中进行了验证。编程算法基于13个腹膜癌指数（PCI）区域纳入了患者的体表面积及其相关的腹膜表面积（PSA）。(3) 结果：患者中位年龄为56岁。中位PCI为9。SAPESUCA显示，所有患者术前平均PSA为18,613 cm²±1951，CRS术后为13,681 cm²±2866。中央PCI区域显示平均腹膜切除范围最大（1517 cm²±737）。腹膜切除范围与PCI评分和术后发病率显著相关。CRS前后模拟的平均奥沙利铂剂量差异显著（558 mg/m²±58.4 vs. 409 mg/m²±86.1；P<0.0001）。(4) 结论：SAPESUCA是首个用于标准化测定CRS术后切除及剩余PSA的免费网络应用程序。该工具可根据剩余PSA调整化疗剂量。
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