Results of complete cytoreductive strategy in patients with peritoneal metastases of colorectal origin with or without extraperitoneal metastases: A bicentric analysis

IF 3.5 2区医学 Q2 ONCOLOGY

Ejso Pub Date : 2024-10-28 DOI:10.1016/j.ejso.2024.108788

Isabelle Sourrouille , Clément Pastier , Maximilliano Gelli , Léonor Benhaïm , Pierre Cattan , Michel Ducreux , Thomas Aparicio , Diane Goéré

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引用次数: 0

Abstract

Background

Increased survival can be achieved in patients with colorectal cancer peritoneal metastases (CRPM) treated with cytoreductive surgery. The benefit of this strategy remains uncertain when CRPM are associated with extraperitoneal metastases (EPM). The aim of this study was to compare short- and long-term outcomes of patients treated with CRS for CRPM, with or without EPM.

Methods

This study included 413 consecutive patients who underwent CRS for CRPM: 120 with EPM (EPM+) and 293 without (EPM-). Patients with isolated ovarian metastases were included in EPM-group (n = 83).

Results

EPM were mainly located to the liver (66 %,n = 79), retroperitoneal lymph nodes (33 %,n = 40); less frequently to the spleen (9 %,n = 12), lung (9 %,n = 10) or pleura (1 %,n = 1). Ovarian metastases were present in 126 patients (83 in EMP-, 43 in EPM+). Peritoneal carcinomatosis index (PCI) was similar in EPM- (8 [4–14]) and EPM+ (8 [3–13],p = 0.335) groups, as postoperative mortality (3 % vs 3 %,p = 1) and major morbidity rates (28 % vs 35 %,p = 0.223). Median overall survival (mOS) and disease-free survival were significantly higher in the EPM-group (58m vs 39m, and 16m vs 10m,p = 0.003). We highlighted 3 prognostic groups 1) EPM-with PCI<10 (mOS 93m), 2) EPM+ with PCI<10 (mOS 57m), 3) EPM-with 10<PCI<15 (mOS 35m) or EPM+ with 10<PCI<15 (mOS 31m) or PCI>15 regardless EPM (mOS 26m, p < 0.001).

Conclusion

Complete cytoreductive surgery seems to be feasible in patients with EPM, without increase in postoperative morbidity and mortality compared to patients without EPM. This strategy provides prolonged survival in selected patients with limited peritoneal metastases from colorectal cancer.

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对伴有或不伴有腹膜外转移的结直肠源性腹膜转移患者采用完全细胞切除策略的结果：双中心分析

背景：结直肠癌腹膜转移（CRPM）患者接受囊肿切除手术治疗可提高生存率。如果结直肠癌腹膜外转移（CRPM）伴有腹膜外转移（EPM），这一策略的益处仍不确定。本研究的目的是比较接受 CRS 治疗的 CRPM 患者的短期和长期疗效，无论是否伴有 EPM：本研究纳入了 413 名连续接受 CRS 治疗的 CRPM 患者：该研究纳入了413名连续接受CRS治疗的CRPM患者：120名伴有EPM（EPM+），293名没有EPM（EPM-）。EPM组包括孤立卵巢转移的患者（n = 83）：EPM主要位于肝脏（66%，n = 79）、腹膜后淋巴结（33%，n = 40）；较少发生在脾脏（9%，n = 12）、肺部（9%，n = 10）或胸膜（1%，n = 1）。126例患者存在卵巢转移（EMP- 83例，EPM+ 43例）。腹膜癌变指数（PCI）在EPM-组（8 [4-14]）和EPM+组（8 [3-13]，P = 0.335）相似，术后死亡率（3 % vs 3 %，P = 1）和主要发病率（28 % vs 35 %，P = 0.223）也相似。EPM组的中位总生存期（mOS）和无病生存期明显高于EPM组（58米 vs 39米，16米 vs 10米，p = 0.003）。我们强调了 3 个预后组 1) EPM-有 PCI15 无 EPM 组（mOS 26m, p 结论：与没有 EPM 的患者相比，对 EPM 患者进行完全细胞剥脱手术似乎是可行的，且不会增加术后发病率和死亡率。这种策略可延长结直肠癌局限性腹膜转移患者的生存期。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Ejso 医学-外科

CiteScore

6.40

自引率

2.60%

发文量

1148

审稿时长

41 days

期刊介绍： JSO - European Journal of Surgical Oncology ("the Journal of Cancer Surgery") is the Official Journal of the European Society of Surgical Oncology and BASO ~ the Association for Cancer Surgery. The EJSO aims to advance surgical oncology research and practice through the publication of original research articles, review articles, editorials, debates and correspondence.