Abstract：
BACKGROUND: Peritoneal sarcomatosis is a rare disease, with multiple histological origins and poor overall prognosis. The option of radical cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) is controversial. The results of a surgical team experienced in these procedures are analyzed and discussed based on the available evidence.
METHODS: Study on a prospective database of patients with peritoneal sarcomatosis who underwent CRS and HIPEC, from 2016 to 2022, in a national reference center for sarcomas and peritoneal oncological surgery, who met the established inclusion/exclusion criteria.
RESULTS: 23 patients were included in the study, with a median age of 53 years (6-68). Recurrent/persistent clinical presentation predominated (78.3%). Visceral origin (including GIST and non-GIST peritoneal) accounted for 47.8% of patients, compared to 43.5% uterine and 8.7% retroperitoneal. The median PCI was 17 (3-36), with CC0 cytoreduction of 87%. Postoperative morbidity (Dindo Clavien III-IV) of 13%, with no postoperative mortality in the series. Overall survival and disease-free survival at 5 years were 64% and 34%, respectively. Histological grade was the most influential prognostic factor for survival.
CONCLUSIONS: The results of the series, with low morbidity, support the benefit of radical peritoneal oncological surgery in patients with peritoneal sarcomatosis after adequate selection, as long as it is performed in high-volume centers, experienced surgeons and expert multidisciplinary teams. However, the role of HIPEC remains to be demonstrated and pending future studies.
METHODS: Study on a prospective database of patients with peritoneal sarcomatosis who underwent CRS and HIPEC, from 2016 to 2022, in a national reference center for sarcomas and peritoneal oncological surgery, who met the established inclusion/exclusion criteria.
RESULTS: 23 patients were included in the study, with a median age of 53 years (6-68). Recurrent/persistent clinical presentation predominated (78.3%). Visceral origin (including GIST and non-GIST peritoneal) accounted for 47.8% of patients, compared to 43.5% uterine and 8.7% retroperitoneal. The median PCI was 17 (3-36), with CC0 cytoreduction of 87%. Postoperative morbidity (Dindo Clavien III-IV) of 13%, with no postoperative mortality in the series. Overall survival and disease-free survival at 5 years were 64% and 34%, respectively. Histological grade was the most influential prognostic factor for survival.
CONCLUSIONS: The results of the series, with low morbidity, support the benefit of radical peritoneal oncological surgery in patients with peritoneal sarcomatosis after adequate selection, as long as it is performed in high-volume centers, experienced surgeons and expert multidisciplinary teams. However, the role of HIPEC remains to be demonstrated and pending future studies.
摘要：
背景：腹膜肉瘤病是一种罕见的疾病，具有多个组织学起源和不良的总体预后。根治性细胞减灭术（CRS）联合腹腔热化疗（HIPEC）的选择存在争议。根据现有证据，对在这些手术中经验丰富的手术团队的结果进行分析和讨论。
方法：对接受CRS和HIPEC的腹膜肉瘤病患者的前瞻性数据库进行研究，从2016年到2022年，在国家肉瘤和腹膜肿瘤外科参考中心，符合既定纳入/排除标准的人。
结果：23名患者被纳入研究，年龄中位数为53岁（6-68岁）。复发/持续的临床表现占主导地位（78.3%）。内脏来源（包括GIST和非GIST腹膜）占患者的47.8％，相比之下，子宫占43.5%，腹膜后占8.7%。中位PCI为17（3-36），CC0细胞减少87%。术后发病率（DindoClavienIII-IV）为13％，系列中无术后死亡率。5年总生存率和无病生存率分别为64%和34%。分别。组织学分级是对生存影响最大的预后因素。
结论：该系列的结果，发病率低，在适当选择后，支持腹膜肉瘤病患者进行根治性腹膜肿瘤手术的益处，只要在高容量中心进行，经验丰富的外科医生和专家多学科团队。然而,HIPEC的作用仍有待证明,有待进一步研究.
方法：对接受CRS和HIPEC的腹膜肉瘤病患者的前瞻性数据库进行研究，从2016年到2022年，在国家肉瘤和腹膜肿瘤外科参考中心，符合既定纳入/排除标准的人。
结果：23名患者被纳入研究，年龄中位数为53岁（6-68岁）。复发/持续的临床表现占主导地位（78.3%）。内脏来源（包括GIST和非GIST腹膜）占患者的47.8％，相比之下，子宫占43.5%，腹膜后占8.7%。中位PCI为17（3-36），CC0细胞减少87%。术后发病率（DindoClavienIII-IV）为13％，系列中无术后死亡率。5年总生存率和无病生存率分别为64%和34%。分别。组织学分级是对生存影响最大的预后因素。
结论：该系列的结果，发病率低，在适当选择后，支持腹膜肉瘤病患者进行根治性腹膜肿瘤手术的益处，只要在高容量中心进行，经验丰富的外科医生和专家多学科团队。然而,HIPEC的作用仍有待证明,有待进一步研究.
