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减瘤手术联合腹腔热灌注化疗治疗腹膜肉瘤病

Cytoreductive Surgery with Hyperthermic Intraperitoneal Chemotherapy for the Treatment of Peritoneal Sarcomatosis.

作者信息

Yurttas Can, Ladurner Ruth, Mihaljević André L, Strohäker Jens

机构信息

Department of General, Visceral and Transplant Surgery, University Hospital Tübingen, Hoppe-Seyler-Str. 3, 72076 Tübingen, Germany.

出版信息

Cancers (Basel). 2024 Aug 30;16(17):3034. doi: 10.3390/cancers16173034.

DOI:10.3390/cancers16173034
PMID:39272890
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11394334/
Abstract

(1) Background: Cytoreductive surgery (CRS) with HIPEC is considered the standard of care for selected patients with peritoneal carcinomatosis, but evidence-based treatment recommendations for the therapy of peritoneal sarcomatosis are scarce. (2) Methods: We retrospectively analyzed all adult patients treated with CRS and HIPEC for peritoneal sarcomatosis between 2017 and 2024. (3) Results: Ten patients with a median age of 46.1 years (range: 23-77 years) with metachronous (40%) or synchronous (60%) peritoneal sarcomatosis from six different tumor entities were treated according to tumor board recommendation using CRS and HIPEC with cisplatin and doxorubicin over 60 min at 42.0 °C. The length of stay in the intensive care unit and hospital was 1.24 (0.6-1.9 days) and 11.1 days (6-17 days), respectively. Complete cytoreduction was achieved in 90% of the patients, with a median PSI of 11.5. Postoperative complications occurred in five cases, but no surgical revisions were necessary, and no acute kidney damage was recorded. (4) Conclusions: CRS with HIPEC in the presence of peritoneal sarcomatosis could be safely performed in our collective. Whether this resulted in an oncological treatment benefit cannot be concluded in view of the heterogeneous and small collective. Therefore, larger and prospective studies are warranted.

摘要

(1)背景:细胞减灭术(CRS)联合腹腔热灌注化疗(HIPEC)被认为是特定腹膜癌患者的标准治疗方法,但针对腹膜肉瘤治疗的循证治疗建议却很少。(2)方法:我们回顾性分析了2017年至2024年间所有接受CRS联合HIPEC治疗腹膜肉瘤的成年患者。(3)结果:10例患者,中位年龄46.1岁(范围:23 - 77岁),患有来自6种不同肿瘤实体的异时性(40%)或同时性(60%)腹膜肉瘤,根据肿瘤委员会的建议,采用CRS联合HIPEC,顺铂和阿霉素在42.0℃下持续60分钟进行治疗。重症监护病房和医院的住院时间分别为1.24天(0.6 - 1.9天)和11.1天(6 - 17天)。90%的患者实现了完全细胞减灭,中位阳性预测指数(PSI)为11.5。5例发生术后并发症,但无需手术修正,未记录到急性肾损伤。(4)结论:在我们的病例组中,CRS联合HIPEC治疗腹膜肉瘤可以安全进行。鉴于病例组的异质性和规模较小,无法得出这是否带来了肿瘤治疗益处的结论。因此,有必要开展更大规模的前瞻性研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6928/11394334/20907e6678c9/cancers-16-03034-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6928/11394334/20907e6678c9/cancers-16-03034-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6928/11394334/20907e6678c9/cancers-16-03034-g001.jpg

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Ann Surg Oncol. 2024 Apr;31(4):2368-2377. doi: 10.1245/s10434-023-14786-5. Epub 2024 Jan 3.
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