Small bowel involvement is a prognostic factor in colorectal carcinomatosis treated with complete cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy
Small bowel involvement is a prognostic factor in colorectal carcinomatosis treated with complete cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy
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DOI：
10.1186/1477-7819-10-56
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发表时间：
2012-04-11
影响因子：
3.2
通讯作者：
Bereder, Jean-Marc
中科院分区：
文献类型：
--
作者：
Benizri, Emmanuel I.;Bernard, Jean-Louis;Bereder, Jean-Marc
背景资料：肿瘤细胞减灭术联合腹腔温热化疗（HIPEC）是治疗腹膜癌转移（PC）的有效方法。我们的目的是确定新的预后因素与PC从结直肠癌患者治疗this procedure.Methods：所有患者PC从结直肠癌治疗HIPEC从2000年1月至2007年12月被前瞻性纳入。采用腹膜癌指数（PCI）评估肿瘤扩展，采用完全性细胞减少评分（CC）记录残留病变。所有的临床和治疗数据进行了计算，在单变量和多变量分析，生存作为主要endpoint.Results：我们进行了51个完整的程序在49个连续的患者。平均PCI为10。CC的分配为：CC-0 = 37，CC-1 = 14。5年总生存率和无进展生存率分别为40%和20%。通过单变量分析确定了几个生存预后因素：PCI < 9（P < 0.001），CC-0与CC-1（P < 0.01）和4区受累（P = 0.06）、区域5（P = 0.031）、区域7（P = 0.014）、区域8（P = 0.022）、区域10（P < 0.0001）和区域11（P = 0.02）。多变量分析中仅远端空肠（10区）受累显著（P = 0.027）。结论：我们证明远端空肠（PCI评分的10区）受累是与不良预后相关的独立因素。
Background: Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC) is a promising treatment for patients with peritoneal carcinomatosis (PC). Our objective was to identify new prognostic factors in patients with PC from colorectal cancer treated with this procedure.Methods: All patients with PC from colorectal cancer treated by HIPEC from January 2000 to December 2007 were prospectively included. The tumor extension was assessed by the Peritoneal Cancer Index (PCI) and the residual disease was recorded using the completeness cytoreductive score (CCs). All clinical and treatment data were computed in univariate and multivariable analyses using survival as primary end point.Results: We carried out 51 complete procedures in 49 consecutive patients. The mean PCI was 10. The allocation of CCs was: CC-0 = 37, CC-1 = 14. The five-year overall and progression-free survival rate were 40% and 20%, respectively. Several prognostic factors for survival were identified by univariate analysis: PCI < 9 (P < 0.001), CC-0 vs. CC-1 (P < 0.01) and involvement of area 4 (P = 0.06), area 5 (P = 0.031), area 7 (P = 0.014), area 8 (P = 0.022), area 10 (P < 0.0001), and area 11 (P = 0.02). Only the involvement of the distal jejunum (area 10) was significant in the multivariable analysis (P = 0.027).Conclusions: We demonstrated that the involvement of area 10 (distal jejunum of the PCI score) was an independent factor associated with poor prognosis.