Cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) has improved the 5-year survival for colorectal cancer (CRC) patients with peritoneal metastases (PM). Little is known about recurrence patterns and recurrence rates between synchronous (S) and metachronous (M) PM following CRS+HIPEC. We aimed to describe the recurrence patterns, overall survival (OS) and disease-free survival (DFS) in S-PM and M-PM patients after complete CRS+HIPEC. From June 2006 to December 2020, a prospective cohort study included 310 CRC patients, where 181 patients had S-PM (58.4%) and 129 patients had M-PM (41.6%). After a median 10.3-month follow-up, 247/310 (79.7%) patients experienced recurrence, and recurrence sites included isolated peritoneal (32.4%), multifocal (peritoneal and liver and/or lung(s)) (22.7%), isolated liver (17.8%), isolated lung (10.5%) and other (16.6%) sites. Recurrence patterns did not differ between S-PM and M-PM. M-PM patients had an impaired DFS compared to S-PM patients (9.4 months (95% CI: 7.3–12.1) vs. 12.5 months (95% CI: 11.2–13.9),p= 0.01). The median OS was similar for S-PM and M-PM (38.4 months (95% CI: 31.2–46.8) vs. 40.8 months (95% CI: 28.8–46.8),p= 0.86). Despite frequent recurrence at extraperitoneal locations, long-term survival was achievable after CRS+HIPEC in CRC patients with PM. The recurrence patterns and OS did not differ between groups, yet M-PM patients had a shorter DFS.
细胞减灭术联合腹腔热灌注化疗提高了结直肠癌腹膜转移患者的5年生存率。目前对于同步性与异时性腹膜转移患者在接受该联合治疗后复发模式及复发率的差异尚不明确。本研究旨在描述完全性细胞减灭术联合腹腔热灌注化疗后，同步性与异时性腹膜转移患者的复发模式、总生存期及无病生存期。2006年6月至2020年12月期间，一项前瞻性队列研究纳入310例结直肠癌患者，其中同步性腹膜转移181例（58.4%），异时性腹膜转移129例（41.6%）。中位随访10.3个月后，247例（79.7%）患者出现复发，复发部位包括孤立性腹膜复发（32.4%）、多灶性复发（腹膜合并肝和/或肺转移）（22.7%）、孤立性肝转移（17.8%）、孤立性肺转移（10.5%）及其他部位（16.6%）。两组复发模式无显著差异。异时性腹膜转移患者的无病生存期较同步性组缩短（9.4个月 vs 12.5个月，p=0.01），但两组总生存期相似（38.4个月 vs 40.8个月，p=0.86）。研究表明，尽管结直肠癌腹膜转移患者在接受细胞减灭术联合腹腔热灌注化疗后常出现腹膜外复发，但仍可获得长期生存。两组复发模式与总生存期无差异，但异时性腹膜转移患者的无病生存期更短。
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