講演情報
[R19-3]腹膜播種を有する大腸癌に対する包括的治療の成績
米村 豊, 重里 親太朗, 左古 昌蔵, 劉 洋 (岸和田徳洲会病院腹膜播種科)
Background: Comprehensive treatment (COMPT) consisting of cytoreductive surgery (CRS) with perioperative chemotherapy (POC) was performed for CRC-patients as a curative treatment for peritoneal metastasis (PM) from colorectal cancer (CRC). Clinical factors contributing cure of CRC patients with PM will be presented.
Methods: between 2006 and 2024, 501 patients were treated with COMPT among 990 CRC-patients with PM. .
Results:
Multi-variate analysis revealed that CCR score, SB-PCI score, LLM (liver/lung metastasis), and HIPEC were independent prognostic factors.
One hundred and seventy patients fulfilled the following factors; PCI less than13, SB-PCI less than 3, No. of involved peritoneal sectors (NIPS) less than 7, no LLM (liver/lung mets), differentiated histologic type, and CCR-0. The median survival time of these patients was 5.5 years, and five and ten- year survival rates were 58％ and 25%. Postoperative grade 3,4,5 complication occurred in 9 (5.3%), 15 (8.8%) and 1 (0.6%), respectively.
Cured patients were defined as those alive without recurrence more than 5 years after CRS. All of the cured patients (N=25) underwent CCR-0 resection. The PCI and SB-PCI of these 25 patients were =<12 and =<2, respectively.
Conclusions: Among CRC-patients with PM, COMPT with CCR-0 resection should is indicated for PCI less than 13, SB-PCI less than 3, number of involved peritoneal segment less than 7, no LLM, and differentiated histologic type.
Methods: between 2006 and 2024, 501 patients were treated with COMPT among 990 CRC-patients with PM. .
Results:
Multi-variate analysis revealed that CCR score, SB-PCI score, LLM (liver/lung metastasis), and HIPEC were independent prognostic factors.
One hundred and seventy patients fulfilled the following factors; PCI less than13, SB-PCI less than 3, No. of involved peritoneal sectors (NIPS) less than 7, no LLM (liver/lung mets), differentiated histologic type, and CCR-0. The median survival time of these patients was 5.5 years, and five and ten- year survival rates were 58％ and 25%. Postoperative grade 3,4,5 complication occurred in 9 (5.3%), 15 (8.8%) and 1 (0.6%), respectively.
Cured patients were defined as those alive without recurrence more than 5 years after CRS. All of the cured patients (N=25) underwent CCR-0 resection. The PCI and SB-PCI of these 25 patients were =<12 and =<2, respectively.
Conclusions: Among CRC-patients with PM, COMPT with CCR-0 resection should is indicated for PCI less than 13, SB-PCI less than 3, number of involved peritoneal segment less than 7, no LLM, and differentiated histologic type.