医学
温热腹腔化疗
传统PCI
外科
倾向得分匹配
结直肠癌
细胞减少术
回顾性队列研究
癌症
卵巢癌
内科学
心肌梗塞
作者
Daichi Kitaguchi,Eun Jung Park,Seung Hyuk Baik,Shoma Sasaki,Yuichiro Tsukada,Masaaki Ito
标识
DOI:10.1097/js9.0000000000000809
摘要
Background: The benefits of hyperthermic intraperitoneal chemotherapy (HIPEC) after cytoreductive surgery (CRS) for colorectal cancer with peritoneal metastasis (CPM) remain controversial. R0 resection without peritoneal stripping might be as effective as CRS plus HIPEC. We aimed to compare the long-term oncological outcomes of patients with CPM and peritoneal cancer index (PCI) scores ≤6 who underwent R0 resection in Japan with those who underwent CRS plus HIPEC in Korea. Materials and Methods: This international, retrospective cohort study was conducted in Korea and Japan using a prospectively collected clinical database. Patients who underwent surgery from July 2014 to December 2021 for CPM with a PCI score of ≤6 and completeness of the cytoreduction score-0 were included. The primary outcome was relapse-free survival (RFS), and the secondary outcomes were overall survival (OS), peritoneal RFS (PRFS), and postoperative outcomes. Results: The 3-year RFS was significantly longer in the CRS+HIPEC group than in the R0 resection group: 35.9% versus 6.9% ( P<0.001 ); 31.0% versus 6.7% ( P=0.040 ) after propensity score matching. The median PRFS was significantly longer in the CRS+HIPEC group than in the R0 resection group: 24.5 months versus 17.2 months ( P=0.017 ). The 3-year OS and postoperative complications did not significantly differ between the two groups. Conclusions: RFS and PRFS rates were significantly prolonged after CRS plus HIPEC, whereas postoperative complications and length of hospital stay were not increased. Therefore, curative CRS plus HIPEC may be considered a treatment strategy for selected patients with resectable CPM and low PCI scores.
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