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Abstract：
BACKGROUND: Cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) is a major treatment of colorectal peritoneal carcinomatosis (CPC). The aim was to determine the disease-free survival (DFS) and overall survival (OS) of patients undergoing CRS-HIPEC for CPC and factors associated with long-term survival (LTS).
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.
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.
摘要：
背景：细胞减灭术（CRS）联合腹腔热化疗（HIPEC）是结直肠腹膜癌（CPC）的主要治疗方法。目的是确定接受CRS-HIPEC治疗的CPC患者的无病生存率（DFS）和总生存率（OS）以及与长期生存率（LTS）相关的因素。
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。
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。
