Impacts of low peritoneal cancer index on the survival outcomes of patient with peritoneal carcinomatosis of colorectal origin

INTERNATIONAL JOURNAL OF SURGERY

卷:23

Article

Huang, Yeqian¹  Alzahrani, Nayef A.^2,3  Chua, Terence C.⁴  Liauw, Winston⁵  Morris, David L.² 

[1] Univ New S Wales, St George Clin Sch, Sydney, NSW 2217, Australia

[2] Univ New S Wales, St George Hosp, Dept Surg, Sydney, NSW 2217, Australia

[3] Imam Muhammad Ibn Saud Islamic Univ, Coll Med, Riyadh, Saudi Arabia

[4] Ryde Hosp, Dept Surg, North Shore Ryde Hlth Serv, Eastwood, NSW, Australia

[5] Univ New S Wales, St George Hosp, Dept Med Oncol, Sydney, NSW 2217, Australia

关键词: Colorectal cancer;    Peritoneal carcinomatosis;    Peritoneal cancer index;   

DOI  :  10.1016/j.ijsu.2015.08.078

来源: Elsevier

【 摘 要 】

Introduction: The combination of cytoreductive surgery (CRS) and perioperative chemotherapy (PIC) have been proposed as an innovative technique for peritoneal carcinomatosis and is currently considered as a standard treatment for colorectal peritoneal carcinomatosis (CRPC) in selected patients. Peritoneal cancer index (PCI) has been suggested to be the most important prognostic factors for the outcomes of patients with CRPC. In this paper, we have studied patients with CRPC and a very low PCI of 5 or less and their survival outcomes. Methods: This is a retrospective study of prospectively collected data of 60 consecutive patients with CRPC and PCI <= 5, who underwent CRS and PIC by the same surgical team at St George hospital in Sydney, Australia between January 1996 and April 2015. Clinical outcomes of these patients were analysed. Results: Hospital mortality was 0%. 14 patients (23.4%) had grade III/IV morbidity. The median follow-up was 22.2 months (range = 0.1-104.2). The median survival was 80.6 months (95% confidence interval (CI) = 35.1-126.1), with an overall 1-year, 3-year, and 5-year survival rate of 96.1%, 72.6% and 54.7% respectively. Among 60 patients, 31 patients experienced the recurrence of the disease (51.7%). The median disease-free survival was 10.8 months (95% CI = 7.2-14.4). Conclusion: This innovative approach combining CRS and PIC has shown encouraging outcomes and offers hope for patients with CRPC. Our results suggest that CRS and PIC can be performed safely to provide significant survival benefits for patients with low volume of disease. Early referral to specialist centre for evaluation is warranted for better survival outcomes. (C) 2015 IJS Publishing Group Limited. Published by Elsevier Ltd. All rights reserved.

【 授权许可】

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