文章：

原发性阑尾癌与结直肠癌腹膜转移的迭代细胞减灭术与腹腔热灌注化疗：一项观察性研究

Iterative Cytoreductive Surgery and HIPEC for Peritoneal Metastases from Primary Appendiceal and Colorectal Cancers: An Observational Study

原文发布日期：17 June 2025

DOI: 10.3390/cancers17122014

类型: Article

开放获取: 是

英文摘要：

Background: Peritoneal relapse after cytoreduction and hyperthermic intraperitoneal chemotherapy (CRS/HIPEC) is common. Repeat CRS/HIPEC offers the potential for long-term survival in the appropriately selected patient.Methods: We performed a retrospective review of a single institution database to assess perioperative outcomes after repeat CRS/HIPEC for appendiceal (pAC) and colorectal (pCRC) cancers. Kaplan–Meier and Cox estimates were used to assess survival.Results: Of 157 patients, 103 patients underwent initial CRS/HIPEC for pAC (n= 67) or pCRC (n= 36) histologies. Twenty-seven pAC patients (27/67, 40%) and 23/36 pCRC patients (63%) developed disease recurrence. Relapsed patients had a higher burden of disease (PCI), operative length and blood loss and received adjuvant chemotherapy (allp< 0.05). Nine of the 27 relapsed pAC patients and 5 of the 13 relapsed pCRC patients underwent repeat CRS/HIPEC. The median time to repeat CRS/HIPEC was 18 months (4–26 months), and a CCR-0 and CCR-1 were achieved in 79% and 21%, respectively. The 1-, 3- and 5-year OS for pAC patients who underwent repeat CRS/HIPEC was 88.9%, 88.9% and 77.8%, and the 1- and 3-year OS for pCRC patients was 100% and 25%, respectively. Repeat CRS/HIPEC for pAC was associated with significant improvement in OS (p= 0.03), while for pCRC, no significant difference was observed (p= 0.99).Conclusions: Repeat CRS/HIPEC for isolated peritoneal recurrence is safe and offers the potential for long-term survival. Patient selection is key to ensure optimal cytoreduction when considering repeat CRS/HIPEC.

摘要翻译： 

背景：细胞减灭术联合腹腔热灌注化疗（CRS/HIPEC）后腹膜复发较为常见。对于经过恰当筛选的患者，重复CRS/HIPEC可能实现长期生存。 方法：本研究通过回顾性分析单中心数据库，评估阑尾癌（pAC）与结直肠癌（pCRC）患者接受重复CRS/HIPEC的围手术期结局。采用Kaplan-Meier法与Cox模型进行生存分析。 结果：在157例患者中，103例因pAC（n=67）或pCRC（n=36）组织学类型接受首次CRS/HIPEC。其中27例pAC患者（27/67，40%）和23例pCRC患者（23/36，63%）出现疾病复发。复发患者具有更高的腹膜癌指数（PCI）、更长的手术时间、更多的术中失血量，且更常接受辅助化疗（所有p值<0.05）。27例复发pAC患者中有9例，13例复发pCRC患者中有5例接受了重复CRS/HIPEC。重复手术的中位间隔时间为18个月（范围4-26个月），达到CCR-0和CCR-1切除标准的比例分别为79%和21%。接受重复CRS/HIPEC的pAC患者1年、3年和5年总生存率分别为88.9%、88.9%和77.8%，pCRC患者1年和3年总生存率分别为100%和25%。重复CRS/HIPEC可显著改善pAC患者总生存期（p=0.03），但对pCRC患者未观察到显著差异（p=0.99）。 结论：针对孤立性腹膜复发的重复CRS/HIPEC是安全的，且可能实现长期生存。在考虑重复CRS/HIPEC时，患者筛选是确保实现最佳细胞减灭效果的关键。

原文链接：

Iterative Cytoreductive Surgery and HIPEC for Peritoneal Metastases from Primary Appendiceal and Colorectal Cancers: An Observational Study