Apoptotic Marker Analysis in Heated-Intraperitoneal Chemotherapy Effluent Fluid Is Associated With Prognosis in Patients With Peritoneal Metastases.

IF 1.9 3区医学 Q3 ONCOLOGY

Journal of Surgical Oncology Pub Date : 2026-05-01 Epub Date: 2026-03-03 DOI:10.1002/jso.70226

Eran Nizri, Yuval Dranizky, Kelly Lipczyc, Ronny Uzana, Almog Ben-Yaakov, Aviram Nissan, Guy Lahat, Yaniv Berger, Ravit Geva

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引用次数: 0

Abstract

Objective: To evaluate apoptotic markers in tumor cells from hyperthermic intraperitoneal chemotherapy (HIPEC) effluent as a biomarker of treatment effectiveness.

Background: Cytoreductive surgery (CRS) combined with HIPEC is used to treat peritoneal surface malignancies (PSM), yet no validated method exists to assess HIPEC efficacy in real time. We explored whether apoptosis in residual tumor cells present in post-HIPEC effluent correlates with oncologic outcomes.

Methods: Forty-four patients undergoing CRS-HIPEC were prospectively enrolled. CD45⁻ cells were stained for Annexin-PI by flow cytometry before and after HIPEC. The apoptotic response (Δapop) was defined as the increase in apoptosis post-HIPEC. Clinical and procedural variables were correlated with peritoneal disease-free survival (pDFS).

Results: Tumor histologies included colorectal (50%), appendiceal (18.2%), ovarian (15.9%), and gastric (11.4%) primaries. Complete cytoreduction was achieved in 81.8% of patients. Median Δapop = 8.5% (IQR: 0%-37%). Responders had significantly prolonged pDFS (median not reached vs. 16 months; p = 0.04). On multivariable analysis, apoptotic response remained a significant predictor of pDFS (HR = 0.22; 95% CI: 0.05-0.87; p = 0.03), independent of PCI and CCR.

Conclusions: In this pilot study, apoptotic markers in HIPEC effluent are a histology-agnostic assay that correlates with recurrence risk. This biomarker may improve patient selection for adjuvant therapies.

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热腹腔化疗流出液中凋亡标志物分析与腹膜转移患者预后的关系

目的：探讨热腹腔化疗（HIPEC）流出液中肿瘤细胞凋亡标志物作为治疗效果的生物标志物。背景：细胞减少手术（CRS）联合HIPEC用于治疗腹膜表面恶性肿瘤（PSM），但没有有效的方法来实时评估HIPEC的疗效。我们探讨了hipec后流出物中残留肿瘤细胞的凋亡是否与肿瘤预后相关。方法：前瞻性纳入44例CRS-HIPEC患者。在HIPEC前后用流式细胞术对CD45毒血症细胞进行Annexin-PI染色。凋亡反应（Δapop）定义为hipec后细胞凋亡的增加。临床和程序变量与腹膜无病生存（pDFS）相关。结果：肿瘤组织学包括结直肠（50%）、阑尾（18.2%）、卵巢（15.9%）和胃（11.4%）原发灶。81.8%的患者实现了完全的细胞减少。中位数Δapop = 8.5% （IQR: 0%-37%）。应答者的pDFS显著延长（未达到中位数vs. 16个月；p = 0.04）。在多变量分析中，凋亡反应仍然是pDFS的重要预测因子（HR = 0.22; 95% CI: 0.05-0.87; p = 0.03），独立于PCI和CCR。结论：在这项初步研究中，HIPEC流出物中的凋亡标志物是一种与复发风险相关的组织学不可知分析。这种生物标志物可以改善患者对辅助治疗的选择。

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

Journal of Surgical Oncology 医学-外科

CiteScore

4.70

自引率

4.00%

发文量

367

审稿时长

2 months

期刊介绍： The Journal of Surgical Oncology offers peer-reviewed, original papers in the field of surgical oncology and broadly related surgical sciences, including reports on experimental and laboratory studies. As an international journal, the editors encourage participation from leading surgeons around the world. The JSO is the representative journal for the World Federation of Surgical Oncology Societies. Publishing 16 issues in 2 volumes each year, the journal accepts Research Articles, in-depth Reviews of timely interest, Letters to the Editor, and invited Editorials. Guest Editors from the JSO Editorial Board oversee multiple special Seminars issues each year. These Seminars include multifaceted Reviews on a particular topic or current issue in surgical oncology, which are invited from experts in the field.