The effect of cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy on peritoneal carcinomatosis from colorectal cancer
10.3760/cma.j.cn112152-20200305-00173
- VernacularTitle:肿瘤细胞减灭术联合腹腔热灌注化疗治疗结直肠癌腹膜癌的疗效
- Author:
Songlin AN
1
;
Kai ZHANG
;
Zhonghe JI
;
Xinbao LI
;
Yang YU
;
Yanbin ZHANG
;
Gang LIU
;
Bing LI
;
Guojun YAN
;
Yan LI
Author Information
1. 首都医科大学附属北京世纪坛医院腹膜肿瘤外科 100038
- Keywords:
Colorectal neoplasms;
Peritoneal carcinomatosis;
Cytoreductive surgery;
Hyperthermic intraperitoneal chemotherapy
- From:
Chinese Journal of Oncology
2021;43(12):1298-1303
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the safety and efficacy of cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy (CRS+ HIPEC) in patients with peritoneal carcinomatosis from colorectal carcinoma (CRC PC).Methods:The clinical and follow-up data of 90 consecutive CRC PC patients underwent CRS+ HIPEC in Beijing Shijitan Hospital from January 2015 to June 2018 were collected. Kaplan-Meier method and parallel Log rank test were used for survival analysis. Cox regression model was used for univariate and multivariate analysis.Results:A total of 90 CRC PC patients underwent CRS+ HIPEC, the median age was 53 years (rage: 13 to 81 years), and 51 cases were male, while other 39 were female. The median overall survival (mOS) was 21.9 months (95%CI: 15.7, 28.1). The 1-, 2-, 3-, and 5-year survival rates were 77.8%, 48.6%, 21.1%, and 5.5%, respectively. The incidence rate of serious adverse event (SAE) was 8.9% (8/90). The mortality rate of perioperative period was 2.2% (2/90). Univariate analysis showed the age ( P=0.040), primary tumor site ( P=0.020), preoperative carbohydrate antigen 125 (CA125) level ( P<0.001), peritoneal cancer index (PCI) ( P<0.001), completeness of cytoreduction (CC) ( P<0.001), ascites ( P=0.012) and postoperative adjuvant chemotherapy ( P<0.001) were significantly associated with the OS. Multivariate Cox-analysis identified preoperative CA125 level( P=0.033), CC of 0 to 1 ( P=0.014), and adjuvant chemotherapy postoperative ( P=0.002) were independent prognostic factor for OS. Conclusions:CRS+ HIPEC can improve survival for CRC PC patients with acceptable morbidity and mortality. Stringent patient selection and complete CRS are two key factors for better survival.
