Department of Peritoneal Cancer Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China.
Department of Peritoneal Cancer Surgery, Beijing Shijitan Hospital, Peking University Ninth School of Clinical Medicine, Beijing, 100038, China.
World J Surg Oncol. 2023 Oct 28;21(1):347. doi: 10.1186/s12957-023-03232-1.
As the standard treatment for pseudomyxoma peritonei (PMP), cytoreductive surgery (CRS) plus hyperthermic intraperitoneal chemotherapy (HIPEC) can significantly prolong the survival of PMP patients, and some patients can even achieve long-term survival (LTS) or clinical cure. The purpose of this study was to analyze the clinicopathological and treatment features of PMP patients with LTS and to explore the survival benefit factors of PMP patients.
The clinicopathological and prognostic data of PMP patients who received CRS + HIPEC at our center from December 2004 to May 2023 were retrospectively analyzed. PMP patients were divided into LTS group (≥ 10 years) and short-term survival (STS) group (< 5 years) according to the length of natural history. Univariate and multivariate analyses were performed to explore the beneficial factors of PMP patients with LTS.
A total of 609 patients with PMP received CRS + HIPEC treatment at our center. Two-hundred one patients with PMP were included in the study after screening, including 39 patients (19.4%) in the LTS group and 162 patients (80.6%) in the STS group. In STS group and LTS group, median overall survival based on natural history was 29.2 (2.4-59.9) vs. 138.9 (120.3-416.7) months. Univariate analysis revealed 8 factors (P < 0.05) with statistically significant differences between the two groups: gender, chemotherapy history, previous surgical score, Karnofsky Performance Status score, pathological diagnosis, lymphatic metastasis, peritoneal cancer index, and completeness of cytoreduction (CC). Multivariate analysis identified only two factors independently associated with LTS of PMP patients: CC and pathological diagnosis.
Complete CRS and pathological features are two key factors affecting LTS in PMP patients.
作为假性黏液瘤腹膜癌（PMP）的标准治疗方法，细胞减灭术（CRS）联合腹腔热灌注化疗（HIPEC）可显著延长 PMP 患者的生存时间，部分患者甚至可实现长期生存（LTS）或临床治愈。本研究旨在分析具有 LTS 的 PMP 患者的临床病理和治疗特征，并探讨影响 PMP 患者 LTS 的生存获益因素。
回顾性分析 2004 年 12 月至 2023 年 5 月在我院接受 CRS+HIPEC 治疗的 PMP 患者的临床病理和预后数据。根据自然病史的长短，将 PMP 患者分为 LTS 组（≥10 年）和短生存期（STS）组（<5 年）。采用单因素和多因素分析探讨影响 PMP 患者 LTS 的获益因素。
共 609 例 PMP 患者在我院接受 CRS+HIPEC 治疗。筛选后共纳入 201 例 PMP 患者，其中 LTS 组 39 例（19.4%），STS 组 162 例（80.6%）。STS 组和 LTS 组的中位总生存期分别为 29.2（2.4-59.9）个月和 138.9（120.3-416.7）个月。单因素分析显示两组有 8 个因素（P<0.05）有统计学差异：性别、化疗史、既往手术评分、卡氏功能状态评分、病理诊断、淋巴转移、腹膜癌指数和肿瘤细胞减灭术完全程度（CC）。多因素分析仅发现 CC 和病理诊断是影响 PMP 患者 LTS 的独立因素。
完全性 CRS 和病理特征是影响 PMP 患者 LTS 的两个关键因素。
