Zhou Hongwei, Wang Hui, Yi Shijie, Yu Shiyao
Affiliated Nanhua Hospital, University of South China, Hengyang, Hunan Province, China.
Int J Colorectal Dis. 2024 Dec 7;39(1):197. doi: 10.1007/s00384-024-04774-w.
Peritoneal metastasis (PM) is the life-threatening cause of colorectal cancer patients (CRC). Adjuvant hyperthermic intraperitoneal chemotherapy (HIPEC) plus cytoreductive surgery exhibited promising effects in preventing recurrence and increasing the survival of CRC patients. However, the outcomes of HIPEC on treating advanced CRC with risk of PM are still controversial. Here, we retrospectively examined the impact of HIPEC on preventing PM and its overall effects on patients with locally advanced CRC who underwent primary curative resection at our center.
We retrospectively analyzed 45 patients diagnosed with locally advanced colorectal cancer (CRC) who underwent primary curative laparoscopic surgery with proactive hyperthermic intraperitoneal chemotherapy (HIPEC), in conjunction with adjuvant systemic chemotherapy at our center between 2019 and 2022. An additional 55 patients with locally advanced CRC who underwent similar surgery and received adjuvant systemic chemotherapy but did not undergo HIPEC during the same period were selected as the control group. Disease-free survival (DFS), overall survival (OS), and PM incidence were compared between patients with and without HIPEC.
The cumulative PM incidence was 2.2% in the HIPEC group and 14.5% in the control group(P = 0.0347). No significant adverse effects were observed in the HIPEC group. Furthermore, Kaplan-Meier survival analysis showed that the HIPEC correlated to better DFS [hazard ratio (HR) 0.4670, 95% confidence interval (CI) 0.2305-0.9462; P = 0.0345] and extended the overall survival of CRC patients [hazard ratio (HR) 0.3978, 95% confidence interval (CI) 0.1684-0.9395; P = 0.0355]. Therefore, our data supports that adjuvant HIPEC can prevent peritoneal failure in CRC patients and improve both PFS and OS survival following primary curative resection.
腹膜转移（PM）是结直肠癌患者（CRC）的致命病因。辅助性腹腔热灌注化疗（HIPEC）联合细胞减灭术在预防复发和提高CRC患者生存率方面显示出有前景的效果。然而，HIPEC治疗有PM风险的晚期CRC的疗效仍存在争议。在此，我们回顾性研究了HIPEC对预防PM的影响及其对在本中心接受初次根治性切除的局部晚期CRC患者的总体效果。
我们回顾性分析了2019年至2022年间在本中心接受初次根治性腹腔镜手术并进行主动腹腔热灌注化疗（HIPEC）联合辅助全身化疗的45例诊断为局部晚期结直肠癌（CRC）的患者。另外选择55例同期接受类似手术并接受辅助全身化疗但未进行HIPEC的局部晚期CRC患者作为对照组。比较接受和未接受HIPEC患者的无病生存期（DFS）、总生存期（OS）和PM发生率。
HIPEC组的累积PM发生率为2.2%，对照组为14.5%（P = 0.0347）。HIPEC组未观察到明显不良反应。此外，Kaplan-Meier生存分析表明，HIPEC与更好的DFS相关[风险比（HR）0.4670，95%置信区间（CI）0.2305 - 0.9462；P = 0.0345]，并延长了CRC患者的总生存期[风险比（HR）0.3978，95%置信区间（CI）0.1684 - 0.9395；P = 0.0355]。因此，我们的数据支持辅助性HIPEC可预防CRC患者的腹膜衰竭，并改善初次根治性切除后的无进展生存期和总生存期。
