Benefit of cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy in patients with isolated peritoneal metastases from colorectal cancer

被引：19
作者：
Piso, Pompiliu [1 ,2 ]
Stierstorfer, Kathrin [3 ]
Gerken, Michael [3 ]
Klinkhammer-Schalke, Monika [3 ]
机构：
[1] Barmherzige Brueder Hosp Regensburg, Dept Gen & Visceral Surg, Pruefeninger Str 86, D-93049 Regensburg, Germany
[2] Krankenhaus Barmherzige Brueder Regensburg, Klin Allgemein & Viszeralchirurg, Pruefeninger Str 86, D-93049 Regensburg, Germany
[3] Univ Inst Qual Assurance & Hlth Serv Res, Tumor Ctr, Am BioPark 9, D-93053 Regensburg, Germany
来源：
INTERNATIONAL JOURNAL OF COLORECTAL DISEASE | 2018年 / 33卷 / 11期
关键词：
Cytoreductive surgery; Hyperthermic intraperitoneal chemotherapy; Colorectal cancer; Peritoneal metastases; Survival analysis; Population-based analysis; SYSTEMIC CHEMOTHERAPY; COLON-CANCER; PLUS HIPEC; HIGH-RISK; CARCINOMATOSIS; MANAGEMENT; MORBIDITY; SELECTION; ORIGIN; TRIALS;
D O I：
10.1007/s00384-018-3146-z
中图分类号：
R57 [消化系及腹部疾病];
学科分类号：
摘要：
BackgroundEver since Sugarbaker has established the cytoreductive surgery (CRS) in combination with intraoperative hyperthermic intraperitoneal chemotherapy (HIPEC), there is a chance of cure for selected patients with peritoneal metastases from colorectal cancer. Objective of this study was to investigate the benefit of CRS and HIPEC compared to other therapy options in patients with isolated synchronous and metachronous peritoneal metastases of colorectal origin in terms of long-term overall survival.MethodsA retrospective population-based cohort study, including 370 patients diagnosed with isolated synchronous and metachronous peritoneal metastases of colorectal origin, was carried out. Therefore, data were acquired from the cancer registry at the Regensburg Tumor Center in Bavaria, Germany. Patients' overall survival (OAS) according to their therapy received was analyzed by means of Kaplan-Meier method and multivariable Cox regression.ResultsOverall median survival was 41.6months for patients treated with CRS and HIPEC, compared with surgery and chemotherapy (24.0months, log-rank p=0.015), chemotherapy only (14.1months, p<0.001), surgery only (11.4months, p<0.001), and best supportive care (7.9months, p<0.001). This benefit persisted after adjustment for further risk factors in multivariable analysis.ConclusionThe effect of CRS and HIPEC stands out significantly in comparison to all other therapies. The multimodality approach should be a regular option for patients with isolated peritoneal metastases.
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收藏
页码：1559 / 1567
页数：9
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