Abstract：
Peritoneal metastases (PM) occur when cancer cells spread inside the abdominal cavity and entail an advanced stage of colorectal cancer (CRC). Prognosis, which is poor, correlates highly with tumour burden, as measured by the peritoneal cancer index (PCI). Cytoreductive surgery (CRS) in specialized centres should be offered especially to patients with a low to moderate PCI when complete resection is expected. The presence of resectable metastatic disease in other organs is not a contraindication in well-selected patients. Although several retrospective and small prospective studies have suggested a survival benefit of adding hyperthermic intraperitoneal chemotherapy (HIPEC) to CRS, the recently published phase III studies PRODIGE-7 in CRC patients with PM, and COLOPEC and PROPHYLOCHIP in resected CRC with high-risk of PM, failed to show any survival advantage of this strategy using oxaliplatin in a 30-min perfusion. Final results from ongoing randomized phase III trials testing CRS plus HIPEC based on mitomycin C (MMC) are awaited with interest. In this article, a group of experts selected by the Spanish Group for the Treatment of Digestive Tumours (TTD) and the Spanish Group of Peritoneal Oncologic Surgery (GECOP), which is part of the Spanish Society of Surgical Oncology (SEOQ), reviewed the role of HIPEC plus CRS in CRC patients with PM. As a result, a series of recommendations to optimize the management of these patients is proposed.
摘要：
当癌细胞在腹腔内扩散并导致结直肠癌（CRC）晚期时，就会发生腹膜转移（PM）。预后,很穷，与肿瘤负荷高度相关，通过腹膜癌指数（PCI）衡量。在预期完全切除的情况下，应特别为低至中度PCI患者提供专门中心的细胞减灭术（CRS）。在选择良好的患者中，其他器官中存在可切除的转移性疾病并不是禁忌症。尽管一些回顾性和小型前瞻性研究表明，在CRS中增加腹腔热化疗（HIPEC）对生存有益，最近发表的III期研究PRODIGE-7在患有PM的CRC患者中，和COLOPEC和PROPHLOCHIP在具有高PM风险的切除CRC中，在30分钟的灌注中使用奥沙利铂未能显示该策略的任何生存优势。正在进行的基于丝裂霉素C（MMC）的CRS加HIPEC的随机III期试验的最终结果正在等待中。在这篇文章中,由西班牙消化性肿瘤治疗小组（TTD）和西班牙腹膜肿瘤外科小组（GECOP）选出的一组专家，它是西班牙外科肿瘤学会（SEOQ）的一部分，综述了HIPEC联合CRS在CRC合并PM患者中的作用。因此,提出了一系列优化这些患者管理的建议。
