METHODS: consecutive CPC patients who underwent CRS-HIPEC at a HIPEC center between 2007 and 2021 were included. Actual survival was calculated, and Cox proportional hazards models were used to identify factors associated with OS, DFS and LTS.
RESULTS: there were 125 patients with CPC who underwent primary CRS-HIPEC, with mean age of 54.5 years. Median follow-up was 31 months. Average intraoperative PCI was 11, and complete cytoreduction (CC-0) was achieved in 96.8%. Median OS was 41.6 months (6-196). The 2-year and 5-year OS were 68% and 24.8%, respectively, and the 2-year DFS was 28.8%. Factors associated with worse OS included pre-HIPEC systemic therapy, synchronous extraperitoneal metastasis, and PCI ≥ 20 (p < 0.05). Progression prior to CRS-HIPEC was associated with worse DFS (p < 0.05). Lower PCI, fewer complications, lower recurrence and longer DFS were associated with LTS (p < 0.05).
CONCLUSIONS: CRS and HIPEC improve OS in CPC patients but they have high disease recurrence. Outcomes depend on preoperative therapy response, extraperitoneal metastasis, and peritoneal disease burden.
方法:纳入2007年至2021年在HIPEC中心接受CRS-HIPEC的连续CPC患者。计算了实际生存率,和Cox比例风险模型用于识别与OS相关的因素,DFS和LTS。
结果:有125例CPC患者接受了原发性CRS-HIPEC,平均年龄54.5岁。中位随访时间为31个月。术中平均PCI为11,完全细胞减灭术(CC-0)达到96.8%。中位OS为41.6个月(6-196)。2年和5年OS分别为68%和24.8%,分别,两年DFS为28.8%。与OS较差相关的因素包括HIPEC系统治疗前,同步腹膜外转移,PCI≥20(p<0.05)。CRS-HIPEC之前的进展与更差的DFS相关(p<0.05)。更低的PCI,更少的并发症,较低的复发和较长的DFS与LTS相关(p<0.05).
结论:CRS和HIPEC可改善CPC患者的OS,但其疾病复发率较高。结果取决于术前治疗反应,腹膜外转移,和腹膜疾病负担。