Division of Surgical Oncology, Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada.
Department of Surgery, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada.
Curr Oncol. 2024 Jun 25;31(7):3657-3668. doi: 10.3390/curroncol31070269.
Cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) is a major treatment of colorectal peritoneal carcinomatosis (CPC). The aim was to determine the disease-free survival (DFS) and overall survival (OS) of patients undergoing CRS-HIPEC for CPC and factors associated with long-term survival (LTS).
consecutive CPC patients who underwent CRS-HIPEC at a HIPEC center between 2007 and 2021 were included. Actual survival was calculated, and Cox proportional hazards models were used to identify factors associated with OS, DFS and LTS.
there were 125 patients with CPC who underwent primary CRS-HIPEC, with mean age of 54.5 years. Median follow-up was 31 months. Average intraoperative PCI was 11, and complete cytoreduction (CC-0) was achieved in 96.8%. Median OS was 41.6 months (6-196). The 2-year and 5-year OS were 68% and 24.8%, respectively, and the 2-year DFS was 28.8%. Factors associated with worse OS included pre-HIPEC systemic therapy, synchronous extraperitoneal metastasis, and PCI ≥ 20 ( < 0.05). Progression prior to CRS-HIPEC was associated with worse DFS ( < 0.05). Lower PCI, fewer complications, lower recurrence and longer DFS were associated with LTS ( < 0.05).
CRS and HIPEC improve OS in CPC patients but they have high disease recurrence. Outcomes depend on preoperative therapy response, extraperitoneal metastasis, and peritoneal disease burden.
细胞减灭术（CRS）联合腹腔热灌注化疗（HIPEC）是结直肠腹膜转移（CPC）的主要治疗方法。目的是确定接受 CPC 行 CRS-HIPEC 治疗的患者的无病生存（DFS）和总生存（OS），并确定与长期生存（LTS）相关的因素。
纳入 2007 年至 2021 年在 HIPEC 中心接受 CPC 行 CRS-HIPEC 的连续 CPC 患者。计算实际生存，并使用 Cox 比例风险模型确定与 OS、DFS 和 LTS 相关的因素。
共有 125 例 CPC 患者接受了原发性 CRS-HIPEC，平均年龄为 54.5 岁。中位随访时间为 31 个月。平均术中 PCI 为 11，96.8%达到完全肿瘤细胞减灭（CC-0）。中位 OS 为 41.6 个月（6-196）。2 年和 5 年 OS 分别为 68%和 24.8%，2 年 DFS 为 28.8%。与 OS 较差相关的因素包括 HIPEC 前全身治疗、同步腹膜外转移和 PCI≥20（<0.05）。CRS-HIPEC 前进展与 DFS 较差相关（<0.05）。较低的 PCI、较少的并发症、较低的复发率和较长的 DFS 与 LTS 相关（<0.05）。
CRS 和 HIPEC 可提高 CPC 患者的 OS，但疾病复发率较高。结果取决于术前治疗反应、腹膜外转移和腹膜疾病负担。
