Manoğlu Berke, Sökmen Selman, Egeli Tufan, Derici Zekai Serhan, Ağalar Cihan, Aksoy Süleyman Özkan
Peritoneal Surface Malignancy Center, Department of Surgery, Dokuz Eylul University Faculty of Medicine, 35340 Balcova, Turkey.
Medicina (Kaunas). 2024 Dec 16;60(12):2070. doi: 10.3390/medicina60122070.
There is no reliable immune scoring system that can help us predict the postoperative outcomes of colorectal cancer patients with peritoneal metastases after cytoreductive surgery. In this cohort, the aims were (1) to evaluate the postoperative morbidity, mortality and surgical oncological outcomes in colorectal cancer patients with peritoneal metastasis; (2) to compare oncological and postoperative outcomes of colon cancer patients with peritoneal metastasis and rectal cancer patients with peritoneal metastasis; and (3) to assess the prognostic value of the modified Glasgow Prognostic Score (mGPS) and the CRP-albumin ratio (CAR). : A prospectively maintained database of 258 patients who underwent cytoreductive surgery for peritoneal metastases of colorectal origin between 2007 and 2024 was analyzed. According to the anatomical location of the primary tumor, two different groups were created: rectum cancer patients with peritoneal metastasis (Group A) and colon cancer patients with peritoneal metastasis (Group B). All standard clinico-pathological characteristics, operative findings, morbi-mortality results, and final oncologic outcomes were compared between Groups A and B. We evaluated whether CAR and mGPS could predict postoperative morbi-mortality and overall survival in the two groups or not. : No significant difference was detected between Groups A and B in terms of clinical-demographic characteristics. In both groups, the preoperative mGPS and CAR values were statistically significantly higher in those who developed postoperative high-grade complications (C-D grade III/IV) ( < 0.001) and those who died perioperatively ( = 0.001 and = 0.002). : In multivariate Cox analysis, the CAR was found to be an independent prognostic factor for overall survival in this cohort. CAR and mGPS predicted high-grade complications and postoperative mortality in both groups.
目前尚无可靠的免疫评分系统能够帮助我们预测接受细胞减灭术后的结直肠癌腹膜转移患者的术后结局。在本队列研究中，目的如下：（1）评估结直肠癌腹膜转移患者的术后发病率、死亡率及外科肿瘤学结局；（2）比较结肠癌腹膜转移患者与直肠癌腹膜转移患者的肿瘤学及术后结局；（3）评估改良格拉斯哥预后评分（mGPS）和CRP-白蛋白比值（CAR）的预后价值。对一个前瞻性维护的数据库进行了分析，该数据库纳入了2007年至2024年间因结直肠源性腹膜转移接受细胞减灭术的258例患者。根据原发肿瘤的解剖位置，创建了两个不同的组：直肠癌腹膜转移患者（A组）和结肠癌腹膜转移患者（B组）。比较了A组和B组之间所有标准的临床病理特征、手术发现、病死结果及最终肿瘤学结局。我们评估了CAR和mGPS能否预测两组患者的术后病死情况及总生存期。A组和B组在临床人口统计学特征方面未检测到显著差异。在两组中，发生术后高级别并发症（C-D级III/IV）的患者（<0.001）以及围手术期死亡的患者（=0.001和=0.002）术前mGPS和CAR值在统计学上显著更高。在多因素Cox分析中发现，CAR是该队列总生存期的独立预后因素。CAR和mGPS可预测两组患者的高级别并发症及术后死亡率。
