Is there an oncological interest in the combination of CRS/HIPEC for peritoneal carcinomatosis of HCC? Results of a multicenter international study

医学 温热腹腔化疗 单变量分析 肝细胞癌 传统PCI 队列 外科 化疗 内科学 回顾性队列研究 癌症 肿瘤科 多元分析 细胞减少术 卵巢癌 心肌梗塞
作者
Sanket Mehta,L. Schwarz,John Spiliotis,Mao‐Chih Hsieh,Eduardo Hiroshi Akaishi,Diane Goèré,Paul H. Sugarbaker,Dario Baratti,François Quénet,David L. Bartlett,Laurent Villeneuve,Vahan Képénékian,Steven A. Ahrendt,Seung Hyuk Baik,Archita Joshi Bhatt,P. Cachin,Wim Ceelen,Ignace de Hingh,Michele De Simone,Pierre Dubé,Robert P. Edwards,Jan Franko,L. González-Bayón,Vadim Gushchin,Matthew P. Holtzman,Mao‐Chih Hsieh,Dragutin Kecmanović,K.W. Lee,Kuno Lehmann,Edward A. Levine,Y. Liu,Sanket Mehta,David L. Morris,Sarah T O’Dwyer,E. Orsenigo,Pankaj Pande,E.J. Park,James F. Pingpank,Pompiliu Piso,Firoz Rajan,Beate Rau,Armando Sardi,Lucas Sidéris,Antonio Sommariva,Antonios Apostolos Tentes,Melissa Ching Ching Teo,Roman Yarema,Yutaka Yonemura,Rami Younan,Shabber Zaveri,H. Zeh,J. Abba,Karine Abboud,Mohammad Alyami,Catherine Arvieux,Naoual Bakrin,Jean-Marc Béréder,D. Bouzard,Cécile Brigand,Sébastien Carrère,Delphine Delroeux,Frédéric Dumont,Clarisse Eveno,Olivier Facy,Frédéric Guyon,Gwénaël Ferron,Olivier Gléhen,Réza Kianmanesh,R. Lo Dico,G. Lorimier,Frédéric Marchal,Pascale Mariani,Pierre Méeus,Simon Msika,Pablo Ortega‐Deballon,Brice Paquette,Guillaume Passot,Patrice Peyrat,N. Pirrò,Marc Pocard,J. Porcheron,Patrick Rat,Olivia Sgarbură,Emilie Thibaudeau,J.‐J. Tuech,Franck Zinzindohoué
出处
期刊:Ejso [Elsevier]
卷期号:44 (11): 1786-1792 被引量:24
标识
DOI:10.1016/j.ejso.2018.05.021
摘要

Peritoneal metastasis (PM) of hepatocellular carcinoma (HCC) without distant spread are rare. The related prognosis is poor without standard treatment available. The role of cytoreduction surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) is poorly documented.An international multicentric cohort was constituted by retrospective analysis of 21 patients undergoing CRS/HIPEC for PM of HCC between 1992 and 2016 from 10 reference centers of PSOGI. Data on clinical features, treatment strategies, and survival outcomes were analyzed.The median time interval from the diagnosis of PM to the procedure was 4.5 months. The median peritoneal cancer index was 14. Sixteen patients had complete cytoreduction (CCR0-1). Ten patients had grades 3 to 4 complications. The median duration of follow-up was 52.2 months. The median OS was 46.7 months. The projected 3y-OS and 5y-OS were 88.9 and 49.4% respectively. The median OS for patients with CCR0-1 resection was not reached whereas it was 5.9 months for those with CCR2-3 resection after CRS (p = 0.0005). The median RFS was 26.3 months and projected RFS at 3 years of 36.5 months Three prognostic factors were associated with improved RFS in the univariate analysis: preoperative chemotherapy (p = 0.0156), PCI >15 (p = 0.009), Number of chemotherapy agents used for HIPEC (p = 0.005).CRS/HIPEC is a safe and effective approach in selected patients with PM of HCC. CRS/HIPEC gives the patient a chance for a good relapse free and overall survival and should be considered as an option.
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