講演情報
[O23-2]腹膜播種を有する大腸癌に対する包括的治療の理論
米村 豊1,2,3, 石橋 治昭1, 左古 昌蔵1, 鍛 利幸1, 伏田 幸夫1, 劉 洋1, 水本 明良2, 高尾 信之2, 池田 聡3 (1.岸和田徳洲会病院, 2.淡海医療センター, 3.池田病院)
The aim of the presentation is to show the theory underlying comprehensive treatment（COMPT）designed to cure colorectal cancer（CRC）patients with peritoneal metastasis（PM）.
There are four curative scenarios following COMPT. Scenario A involves cases without MM, where patients can potentially be cured by complete cytoreductive surgery（CCRS）alone. Similarly, if the residual number of MM is below the threshold level that can be completely eliminated by IOHIPEC, patients will be cured by CCRS plus IOHIPEC（Scenario C）.
If neoadjuvant chemotherapy（NAC）reduces the MM burden below the threshold level, patients may then be cured by CCRS combined with HIPEC（Scenario D）. If NAC completely eliminates MM, patients will then be cured by CCRS alone（Scenario F）. Cure is defined as survival without recurrence for longer than 5 years after following COMPT.
The number of patients achieving a cure was 27/304（8.9％）, and the PCI was ≤ 12.
Among 304 CRC-patients with PM who underwent CCRS, 10 patients treated with CCRS alone, and one patient with peritoneal cancer index（PCI）of 4 was cured（Scenario A）. Three（20％）of 15 patients treated with CCRS plus IOHIPEC were cured. Four（5.5％）of 73 patients treated with NAC plus CCRS, were cured（Scenario F）. Nineteen（9.2％）of 206 patients treated with CCRS plus HIPC after NAC were cured（Scenario C or D）.
Conclusions：Patients with a PCI ≤ 12 could be cured with CCRS plus perioperative chemotherapy.
There are four curative scenarios following COMPT. Scenario A involves cases without MM, where patients can potentially be cured by complete cytoreductive surgery（CCRS）alone. Similarly, if the residual number of MM is below the threshold level that can be completely eliminated by IOHIPEC, patients will be cured by CCRS plus IOHIPEC（Scenario C）.
If neoadjuvant chemotherapy（NAC）reduces the MM burden below the threshold level, patients may then be cured by CCRS combined with HIPEC（Scenario D）. If NAC completely eliminates MM, patients will then be cured by CCRS alone（Scenario F）. Cure is defined as survival without recurrence for longer than 5 years after following COMPT.
The number of patients achieving a cure was 27/304（8.9％）, and the PCI was ≤ 12.
Among 304 CRC-patients with PM who underwent CCRS, 10 patients treated with CCRS alone, and one patient with peritoneal cancer index（PCI）of 4 was cured（Scenario A）. Three（20％）of 15 patients treated with CCRS plus IOHIPEC were cured. Four（5.5％）of 73 patients treated with NAC plus CCRS, were cured（Scenario F）. Nineteen（9.2％）of 206 patients treated with CCRS plus HIPC after NAC were cured（Scenario C or D）.
Conclusions：Patients with a PCI ≤ 12 could be cured with CCRS plus perioperative chemotherapy.