文章：

腹膜癌指数是结直肠腹膜转移患者接受CRS–HIPEC治疗后预后的主要决定因素：一项连续单中心队列的3年随访研究

Peritoneal Cancer Index Dominates Prognosis After CRS–HIPEC for Colorectal Peritoneal Metastases: A Consecutive Single-Centre Cohort with 3-Year Follow-Up

原文发布日期：10 November 2025

DOI: 10.3390/cancers17223614

类型: Article

开放获取: 是

英文摘要：

Background: Cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) can cure selected patients with colorectal peritoneal metastases (CPM). Real-world prognostic data, especially for the Peritoneal Cancer Index (PCI) and completeness of cytoreduction (CCR), are limited. Methods: We retrospectively analysed 75 consecutive patients treated with CRS + HIPEC at a tertiary centre (2014–2022), giving ≥36 months potential follow-up. Overall survival (OS) was assessed by Kaplan–Meier and Cox models. PCI was grouped 0–10, 11–20, >20; CCR was dichotomised (CCR-0 vs. CCR 1/2). Multivariable analysis included PCI, CCR, and resection extent; HIPEC drug was examined univariately. Results: The median follow-up was 41 months. Crude 3-year OS was 50.7% (38/75). Survival decreased with higher PCI: 69% for 0–10 (n= 42), 38% for 11–20 (n= 21), and 0% for > 20 (n= 4). Versus PCI 0–10, the adjusted hazard ratios (HR) were 3.02 (95% CI 1.52–6.03) for PCI 11–20 and 7.29 (1.72–30.81) for > 20. CCR-0 improved OS univariately (HR 0.43) but was non-significant after adjustment (HR 0.89). Resection limited to the peritoneum (HR 0.99) and choice of intraperitoneal drug showed no independent effect. Conclusions: In this real-world cohort, PCI was the only independent predictor of 3-year survival after CRS + HIPEC for CPM; neither CCR status, surgical extent, nor HIPEC agent altered prognosis once PCI was considered. PCI should therefore remain the principal selection criterion while molecular and biological markers are integrated into future risk models.

摘要翻译： 

背景：细胞减灭术联合腹腔热灌注化疗可治愈部分结直肠癌腹膜转移患者。关于腹膜癌指数和细胞减灭完整度的真实世界预后数据仍较为有限。方法：本研究回顾性分析了2014年至2022年间在三级医疗中心连续接受细胞减灭术联合腹腔热灌注化疗治疗的75例患者，所有病例均具备至少36个月的潜在随访期。采用Kaplan-Meier法和Cox模型评估总生存期。将腹膜癌指数分为0-10、11-20、>20三组；细胞减灭完整度分为完全切除与次全切除两类。多变量分析纳入腹膜癌指数、细胞减灭完整度及切除范围；对腹腔热灌注化疗药物进行单因素分析。结果：中位随访时间为41个月。3年总生存率为50.7%（38/75）。生存率随腹膜癌指数升高而递减：0-10分组为69%（42例），11-20分组为38%（21例），>20分组为0%（4例）。以0-10分组为参照，调整后风险比分别为：11-20分组3.02（95%置信区间1.52-6.03），>20分组7.29（1.72-30.81）。单因素分析显示完全切除可改善总生存期（风险比0.43），但经多因素调整后无统计学意义（风险比0.89）。单纯腹膜切除术式（风险比0.99）及腹腔化疗药物选择均未显示独立预后价值。结论：在本真实世界队列中，腹膜癌指数是结直肠癌腹膜转移患者接受细胞减灭术联合腹腔热灌注化疗后3年生存率的唯一独立预测因子；在考虑腹膜癌指数后，细胞减灭完整度、手术范围及腹腔热灌注化疗药物均未改变预后。因此腹膜癌指数应作为主要筛选标准，同时需将分子与生物学标志物纳入未来风险预测模型。

原文链接：

Peritoneal Cancer Index Dominates Prognosis After CRS–HIPEC for Colorectal Peritoneal Metastases: A Consecutive Single-Centre Cohort with 3-Year Follow-Up