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Abdominal tuberculosis mimicking peritoneal metastasis. 模拟腹膜转移的腹部结核。
IF 1.8 Q2 Medicine Pub Date : 2023-09-01 DOI: 10.1515/pp-2023-0012
Ragad I Al Jazzar, Zeinah Sulaihim, Ahmad Alkhiary, Nayef Alzahrani
Peritoneal tuberculosis is a rare form of extrapulmonary tuberculosis. This challenge is attributed to its great mimicry of other peritoneal disease processes along with its nonspeci fi c clinical presentation. We report a case of a 60-year old man, known case of rectosigmoid cancer with liver and lung nodules. Status post low anterior resection,
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引用次数: 0
Prognostic value of preoperative serological biomarkers in patients undergoing cytoreductive surgery for ovarian cancer peritoneal metastases. 术前血清学生物标志物在卵巢癌腹膜转移患者行细胞减缩手术中的预后价值。
IF 1.8 Q2 Medicine Pub Date : 2023-09-01 DOI: 10.1515/pp-2022-0199
Charif Khaled, Antoine El Asmar, Omar Raisi, Michel Moreau, Laura Polastro, Isabelle Veys, Florin C Pop, Vincent Donckier, Gabriel Liberale

Objectives: Peritoneal metastases of ovarian cancer (PMOC) are common at initial presentation. Cytoreductive surgery (CRS) of curative intent has been proven to be efficient in increasing the overall survival (OS) and the disease-free survival (DFS) of these patients. Nevertheless, CRS is associated with high postoperative morbidity, which makes patient selection a major concern. Appropriate prognostic factors that can predict patient outcomes after surgery are still lacking. Preoperative biomarkers and their ratios have been shown to be predictive of patient prognosis for various solid tumors. We aimed to study their correlation with the prognosis of patients undergoing CRS for PMOC.

Methods: This retrospective study included patients with PMOC operated by CRS. Preoperative biomarkers and other clinicopathological characteristics were studied to determine their prognostic value in terms OS and DFS.

Results: 216 patients were included. Patients with preoperative hemoglobin (Hb) <11.7 g/dL had a poorer prognosis in terms of OS (p=0.0062) and DFS (p=0.0077). Additionally, increased neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR) >0.32, and platelet-to-lymphocyte ratio (PLR) >214.5 were associated with worse OS (p=0.022, p=0.0028, and p=0.0018, respectively) and worse DFS (p=0.028, p=0.003, and p=0.019, respectively). Multivariate analysis showed that the variables mentioned above were independent predictive factors for OS and DFS.

Conclusions: Preoperative Hb level, NLR, MLR, and PLR are prognostic factors for OS and DFS in PMOC patients operated by curative CRS.

目的:卵巢癌腹膜转移(PMOC)在最初的表现是常见的。具有治疗目的的细胞减少手术(CRS)已被证明可有效提高这些患者的总生存期(OS)和无病生存期(DFS)。然而,CRS与术后高发病率相关,这使得患者选择成为一个主要问题。目前仍缺乏能够预测手术后患者预后的适当预后因素。术前生物标志物及其比值已被证明可以预测各种实体瘤的预后。我们的目的是研究它们与PMOC患者接受CRS的预后的相关性。方法:回顾性研究采用CRS手术的PMOC患者。研究术前生物标志物和其他临床病理特征,以确定其在OS和DFS方面的预后价值。结果:共纳入216例患者。术前血红蛋白(Hb) 0.32、血小板与淋巴细胞比值(PLR) >214.5的患者,OS加重(p=0.022、p=0.0028、p=0.0018), DFS加重(p=0.028、p=0.003、p=0.019)。多因素分析表明,上述变量是OS和DFS的独立预测因素。结论:术前Hb水平、NLR、MLR和PLR是治疗性CRS手术PMOC患者OS和DFS的预后因素。
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引用次数: 1
Investigation of the effectiveness of hyperthermic intraperitoneal chemotherapy in experimental colorectal peritoneal metastasis model. 腹腔热化疗对实验性大肠癌腹膜转移模型的影响。
IF 1.8 Q2 Medicine Pub Date : 2023-09-01 DOI: 10.1515/pp-2023-0002
Berke Manoğlu, Tuğba Yavuzşen, Safiye Aktaş, Zekiye Altun, Osman Yılmaz, Özde Elif Gökbayrak, Aylin Erol

Objectives: In our study, we aimed to (1) create a peritoneal metastasis (PM) model in nude mice, administer intraperitoneal chemotherapy using the peritoneal infusion pump we developed in this model, and (2) compare the efficacy of intraperitoneal chemotherapy using various drugs at different temperatures.

Methods: The peritoneal metastasis model was established in nude mice using the CC531 colon carcinoma cell line. Models with peritoneal metastasis (PM) were randomized into four groups of seven animals each: Group 1, control group (n=7); Group 2, normothermic intraperitoneal chemotherapy (NIPEC) with mitomycin C(MMC) (n=7); Group 3, hyperthermic intraperitoneal chemotherapy (HIPEC) with mitomycin C (n=7), and Group 4, NIPEC with 5-fluorouracil (5-FU).

Results: Tumor development was achieved in all animals. While the tumor burden decreased significantly in the treatment Group 3 (p=0.034), no significant difference was found in the other groups. In the PM mouse model, hyperthermic intraperitoneal administration of MMC had the highest tumoricidal effect.

Conclusions: Our PM model provided a good opportunity to examine the efficacy of HIPEC and intraperitoneal infusion pump (IPIP). In future studies, we plan to evaluate efficacies of different drugs in the PM models we have created.

目的:在我们的研究中,我们的目的是(1)建立裸鼠腹膜转移(PM)模型,使用我们在该模型中开发的腹膜输注泵进行腹腔化疗,(2)比较不同温度下不同药物腹腔化疗的效果。方法:采用CC531结肠癌细胞系建立裸鼠腹膜转移模型。腹腔转移模型随机分为4组,每组7只:1组,对照组(n=7);2组,常温腹腔化疗(NIPEC)联合丝裂霉素C(MMC) (n=7);第3组采用丝裂霉素C腹腔热化疗(HIPEC) (n=7),第4组采用5-氟尿嘧啶腹腔热化疗(NIPEC) (5-FU)。结果:所有动物均有肿瘤发生。治疗组3肿瘤负荷明显降低(p=0.034),其他组间差异无统计学意义。在PM小鼠模型中,温热腹腔注射MMC具有最高的肿瘤杀伤作用。结论:我们的PM模型提供了一个很好的机会来检验HIPEC和腹腔内输液泵(IPIP)的疗效。在未来的研究中,我们计划在我们创建的PM模型中评估不同药物的疗效。
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引用次数: 0
Embryological, anatomical and clinical considerations on pleuroperitoneal communication. 胸膜-腹膜沟通的胚胎学、解剖学和临床考虑。
IF 1.8 Q2 Medicine Pub Date : 2023-09-01 DOI: 10.1515/pp-2023-0013
Christodoulos Chatzigrigoriadis, Anastasios Goulioumis, Despoina Sperdouli, Kostis Gyftopoulos

The pleural and peritoneal cavity share many related features due to their common celomic origin. Normally these two spaces are completely separated with the development of the diaphragm. Defects in diaphragm morphogenesis may result in congenital diaphragmatic hernias, which is the most known form of communication between the pleural and peritoneal cavity. However, in several cases, findings of pleuroperitoneal communication (PPC) have been described in adults through an apparently intact diaphragm. In this comprehensive review we systematically evaluate clinical scenarios of this form of "unexpected" PPC as reported in the literature and focus on the possible mechanisms involved.

胸膜腔和腹膜腔由于其共同的经济起源而具有许多相关的特征。通常这两个空间是完全分开的隔膜的发展。横膈膜形态发生的缺陷可能导致先天性膈疝,这是胸膜和腹膜腔之间最常见的沟通形式。然而,在一些病例中,发现胸膜腹膜通信(PPC)在成人通过一个明显完整的横膈膜。在这篇全面的综述中,我们系统地评估了文献中报道的这种形式的“意外”PPC的临床情况,并重点关注可能涉及的机制。
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引用次数: 0
Early postoperative CRP predicts major complications following cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC). 术后早期CRP可预测细胞减少手术(CRS)和腹腔热化疗(HIPEC)后的主要并发症。
IF 1.8 Q2 Medicine Pub Date : 2023-09-01 DOI: 10.1515/pp-2022-0203
Akash Kartik, Catharina Müller, Miklos Acs, Pompiliu Piso, Patrick Starlinger, Thomas Bachleitner-Hofmann, Travis E Grotz

Objectives: Cytoreductive surgery (CRS) and heated intraperitoneal chemotherapy (HIPEC) is associated with significant postoperative complications. Early detection of at-risk patients may lead to improved outcomes. The role of C-reactive protein (CRP) in predicting postoperative complications has only been recently investigated.

Methods: Postoperative complications were categorized according to Clavien-Dindo classification and further divided into minor (Grade <3) and major complications (Grade ≥3A). Absolute CRP counts (mg/L) on postoperative days (POD) 1-7, and proportional change in CRP was compared and the area under (AUC) receiver operating characteristics (ROC) curve was calculated. Univariate and multivariate analysis was performed. Significant findings were externally validated.

Results: Twenty-five percent of patients experienced one or more major complications. A CRP level of ≥106 mg/L on POD 2 and 65.5 mg/L on POD 4 were significantly associated with an increased risk of major complications with an AUC of 0.658 and 0.672, respectively. The proportional increase in CRP between POD 1 and 4 (ΔCRP POD 1/4) at a cut-off of 30 % had the best AUC of 0.744 and was the only independent risk factor for major complications (p<0.0001) on multivariate analysis. ∆CRP had an AUC of 0.716 (p=0.002) when validated in an independent database.

Conclusions: CRP can be used in a variety of ways to predict major complications after CRS and HIPEC. However, the ∆CRP POD 1/4>30 % is the best indicator of major complications. Serial CRP measurements in the early postoperative period may lead to early detection of patients at risk of major complications allowing for alternative management strategies to improve outcomes.

目的:细胞减少手术(CRS)和腹腔内加热化疗(HIPEC)与显著的术后并发症相关。早期发现高危患者可能会改善预后。c反应蛋白(CRP)在预测术后并发症中的作用直到最近才被研究。方法:术后并发症按照Clavien-Dindo分类进行分类,并进一步分为轻微并发症(分级结果:25%的患者出现一种或多种主要并发症。POD 2上CRP水平≥106 mg/L和POD 4上CRP水平≥65.5 mg/L与主要并发症风险增加显著相关,AUC分别为0.658和0.672。CRP在POD 1和4 (ΔCRP POD 1/4)之间的比例增加(截点为30 %)的最佳AUC为0.744,是主要并发症的唯一独立危险因素(结论:CRP可用于多种方法预测CRS和HIPEC后的主要并发症。然而,∆CRP POD 1/4>30 %是主要并发症的最佳指标。术后早期连续测量CRP可能导致早期发现有主要并发症风险的患者,从而允许采用其他管理策略来改善预后。
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引用次数: 0
Frontmatter 头版头条
Q2 Medicine Pub Date : 2023-08-31 DOI: 10.1515/pp-2023-frontmatter3
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引用次数: 0
Outcomes after curatively intended treatment of limited peritoneal metastases and thermal ablation for liver metastases from colorectal cancer. 结直肠癌局限性腹膜转移和肝转移热消融治疗后的疗效。
IF 1.8 Q2 Medicine Pub Date : 2023-07-24 eCollection Date: 2023-12-01 DOI: 10.1515/pp-2023-0015
Rogini Balachandran, Mette Møller Sørensen, Jonas Amstrup Funder, Anders Riegels Knudsen, Lene Hjerrild Iversen

Objectives: Peritoneal metastases (PM) and liver metastases (LM) are present simultaneously in up to 2 % of patients at the time of their colorectal cancer (CRC) diagnosis. Curatively intended treatment includes cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) combined with LM resection. A less invasive treatment for LM is ablation. We aimed to estimate overall survival (OS), disease-free survival (DFS) and postoperative data in patients managed simultaneously with CRS, HIPEC and radiofrequency ablation (RFA) as first choice.

Methods: This was a retrospective national cohort study. All patients were treated at Aarhus University Hospital; the only CRS+HIPEC centre in Denmark. We included CRC patients managed with curative intent for simultaneously diagnosed PM and LM in the period January 2016 - December 2021. LM was treated with RFA as first choice, if possible. Survival was calculated by the Kaplan-Meier method.

Results: A total of 25 patients were included, the median age was 60 years (range 43-75 years) and 15 (60 %) were females. The median peritoneal cancer index was 7 (range 0-12), the median number of LM was 1 (range 1-3). Ablation was performed as the only treatment for LM in 18 (72 %) patients. After a median follow-up time of 17.1 months (range 4-36 months), the median OS was 28.6 months (95 % confidence interval (Cl) 15.8;36.1), 1-year OS was 84.0 % (95 % Cl 62.8;93.7). Median DFS was 6.1 months (95 % Cl 4.0;10.3). Median LOS was ten days (range 5-26 days). Both 30-day and 90-day mortality were 0 %.

Conclusions: The selected treatment modality (RFA) for CRC patients with both LM and PM was safe. However, DFS was low. Further research is warranted to investigate if RFA is as effective as LM resection.

目的:多达 2% 的患者在确诊结直肠癌(CRC)时同时存在腹膜转移灶(PM)和肝转移灶(LM)。根治性治疗包括囊肿切除手术(CRS)和腹腔内热化疗(HIPEC),并结合肝转移灶切除术。LM的微创治疗是消融术。我们的目的是估算同时接受CRS、HIPEC和射频消融术(RFA)作为首选治疗的患者的总生存期(OS)、无病生存期(DFS)和术后数据:这是一项回顾性全国队列研究。所有患者均在奥胡斯大学医院接受治疗,该医院是丹麦唯一一家CRS+HIPEC中心。我们纳入了2016年1月至2021年12月期间因同时确诊PM和LM而接受治愈性治疗的CRC患者。如果可能,LM首选RFA治疗。采用卡普兰-梅尔法计算生存率:共纳入25名患者,中位年龄为60岁(43-75岁),女性15人(60%)。腹膜癌指数中位数为 7(范围 0-12),LM 中位数为 1(范围 1-3)。18例(72%)患者的腹膜癌只接受了消融治疗。中位随访时间为17.1个月(4-36个月),中位OS为28.6个月(95%置信区间(Cl)为15.8;36.1),1年OS为84.0%(95%置信区间(Cl)为62.8;93.7)。中位 DFS 为 6.1 个月(95 % 置信区间为 4.0;10.3)。中位 LOS 为 10 天(5-26 天不等)。30天和90天死亡率均为0%:结论:对于同时患有LM和PM的CRC患者,所选的治疗方式(RFA)是安全的。然而,DFS较低。有必要进一步研究 RFA 是否与 LM 切除术一样有效。
{"title":"Outcomes after curatively intended treatment of limited peritoneal metastases and thermal ablation for liver metastases from colorectal cancer.","authors":"Rogini Balachandran, Mette Møller Sørensen, Jonas Amstrup Funder, Anders Riegels Knudsen, Lene Hjerrild Iversen","doi":"10.1515/pp-2023-0015","DOIUrl":"10.1515/pp-2023-0015","url":null,"abstract":"<p><strong>Objectives: </strong>Peritoneal metastases (PM) and liver metastases (LM) are present simultaneously in up to 2 % of patients at the time of their colorectal cancer (CRC) diagnosis. Curatively intended treatment includes cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) combined with LM resection. A less invasive treatment for LM is ablation. We aimed to estimate overall survival (OS), disease-free survival (DFS) and postoperative data in patients managed simultaneously with CRS, HIPEC and radiofrequency ablation (RFA) as first choice.</p><p><strong>Methods: </strong>This was a retrospective national cohort study. All patients were treated at Aarhus University Hospital; the only CRS+HIPEC centre in Denmark. We included CRC patients managed with curative intent for simultaneously diagnosed PM and LM in the period January 2016 - December 2021. LM was treated with RFA as first choice, if possible. Survival was calculated by the Kaplan-Meier method.</p><p><strong>Results: </strong>A total of 25 patients were included, the median age was 60 years (range 43-75 years) and 15 (60 %) were females. The median peritoneal cancer index was 7 (range 0-12), the median number of LM was 1 (range 1-3). Ablation was performed as the only treatment for LM in 18 (72 %) patients. After a median follow-up time of 17.1 months (range 4-36 months), the median OS was 28.6 months (95 % confidence interval (Cl) 15.8;36.1), 1-year OS was 84.0 % (95 % Cl 62.8;93.7). Median DFS was 6.1 months (95 % Cl 4.0;10.3). Median LOS was ten days (range 5-26 days). Both 30-day and 90-day mortality were 0 %.</p><p><strong>Conclusions: </strong>The selected treatment modality (RFA) for CRC patients with both LM and PM was safe. However, DFS was low. Further research is warranted to investigate if RFA is as effective as LM resection.</p>","PeriodicalId":20231,"journal":{"name":"Pleura and Peritoneum","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2023-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10739284/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90459696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Overall survival and morbidity are not associated with advanced age for cytoreductive surgery and hyperthermic intraperitoneal chemotherapy: a single centre experience. 总生存率和发病率与细胞减少手术和腹腔内高温化疗的高龄无关:单中心经验。
IF 1.8 Q2 Medicine Pub Date : 2023-06-01 DOI: 10.1515/pp-2022-0202
Ernest Cheng, Raphael Shamavonian, Jasmine Mui, Raymond Hayler, Josh Karpes, Ruwanthi Wijayawardana, Shoma Barat, Nima Ahmadi, David L Morris

Objectives: Cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS/HIPEC) has enabled better prognosis for patients with peritoneal surface malignancies. However, in older age groups, short -and long-term outcomes are still perceived as poor. We evaluated patients aged 70 and over and determine if age is a predictor of morbidity, mortality and overall survival (OS).

Methods: A retrospective cohort analysis was performed on CRS/HIPEC patients and categorised by age. The primary outcome was overall survival. Secondary outcomes included morbidity, mortality, hospital and incentive care unit (ICU) stay and early postoperative intraperitoneal chemotherapy (EPIC).

Results: A total of 1,129 patients were identified with 134 aged 70+ and 935 under 70. There was no difference in OS (p=0.175) or major morbidity (p=0.051). Advanced age was associated with higher mortality (4.48 vs. 1.11 %, p=0.010), longer ICU stay (p<0.001) and longer hospitalisation (p<0.001). The older group was less likely to achieve complete cytoreduction (61.2 vs. 73 %, p=0.004) and receive EPIC (23.9 vs. 32.7 %, p=0.040).

Conclusions: In patients undergoing CRS/HIPEC, age of 70 and above does not impact OS or major morbidity but is associated with increased mortality. Age alone should not be a limiting factor in selecting CRS/HIPEC patients. Careful multi-disciplinary approach is needed when considering those of advanced age.

目的:细胞减少手术联合腹腔热化疗(CRS/HIPEC)使腹膜表面恶性肿瘤患者的预后更好。然而,在年龄较大的群体中,短期和长期的结果仍然被认为很差。我们评估了70岁及以上的患者,并确定年龄是否是发病率、死亡率和总生存率(OS)的预测因子。方法:对CRS/HIPEC患者进行回顾性队列分析,并按年龄分类。主要终点是总生存期。次要结局包括发病率、死亡率、住院和激励护理单位(ICU)住院时间以及术后早期腹腔内化疗(EPIC)。结果:共发现1129例患者,其中70岁以上134例,70岁以下935例。总生存率(p=0.175)和主要发病率(p=0.051)差异无统计学意义。高龄与较高的死亡率(4.48 vs. 1.11 %,p=0.010)、较长的ICU住院时间相关(p结论:在接受CRS/HIPEC的患者中,70岁及以上年龄对OS或主要发病率没有影响,但与死亡率增加相关。年龄本身不应成为选择CRS/HIPEC患者的限制因素。在考虑高龄患者时,需要谨慎的多学科方法。
{"title":"Overall survival and morbidity are not associated with advanced age for cytoreductive surgery and hyperthermic intraperitoneal chemotherapy: a single centre experience.","authors":"Ernest Cheng,&nbsp;Raphael Shamavonian,&nbsp;Jasmine Mui,&nbsp;Raymond Hayler,&nbsp;Josh Karpes,&nbsp;Ruwanthi Wijayawardana,&nbsp;Shoma Barat,&nbsp;Nima Ahmadi,&nbsp;David L Morris","doi":"10.1515/pp-2022-0202","DOIUrl":"https://doi.org/10.1515/pp-2022-0202","url":null,"abstract":"<p><strong>Objectives: </strong>Cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS/HIPEC) has enabled better prognosis for patients with peritoneal surface malignancies. However, in older age groups, short -and long-term outcomes are still perceived as poor. We evaluated patients aged 70 and over and determine if age is a predictor of morbidity, mortality and overall survival (OS).</p><p><strong>Methods: </strong>A retrospective cohort analysis was performed on CRS/HIPEC patients and categorised by age. The primary outcome was overall survival. Secondary outcomes included morbidity, mortality, hospital and incentive care unit (ICU) stay and early postoperative intraperitoneal chemotherapy (EPIC).</p><p><strong>Results: </strong>A total of 1,129 patients were identified with 134 aged 70+ and 935 under 70. There was no difference in OS (p=0.175) or major morbidity (p=0.051). Advanced age was associated with higher mortality (4.48 vs. 1.11 %, p=0.010), longer ICU stay (p<0.001) and longer hospitalisation (p<0.001). The older group was less likely to achieve complete cytoreduction (61.2 vs. 73 %, p=0.004) and receive EPIC (23.9 vs. 32.7 %, p=0.040).</p><p><strong>Conclusions: </strong>In patients undergoing CRS/HIPEC, age of 70 and above does not impact OS or major morbidity but is associated with increased mortality. Age alone should not be a limiting factor in selecting CRS/HIPEC patients. Careful multi-disciplinary approach is needed when considering those of advanced age.</p>","PeriodicalId":20231,"journal":{"name":"Pleura and Peritoneum","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10249755/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9619027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Correlation between PSOGI pathological classification and survival outcomes of patients with pseudomyxoma peritonei treated using cytoreductive surgery and HIPEC: national referral centre experience and literature review. 腹腔假性黏液瘤PSOGI病理分型与HIPEC治疗患者生存结局的相关性:国家转诊中心经验及文献综述。
IF 1.8 Q2 Medicine Pub Date : 2023-06-01 DOI: 10.1515/pp-2023-0001
Lorena Martín-Román, Enda Hannan, Mohammad Faraz Khan, Anna Sophia Müller, Conor Shields, John Aird, Brendan Moran, Jurgen Mulsow

Objectives: The Peritoneal Surface Oncology Group International (PSOGI) consensus subdivided pseudomyxoma peritonei (PMP) into four groups according to histopathological features. The aim of this paper is to report survival outcomes after cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) from a national referral centre and to correlate the PSOGI classification with survival.

Methods: A retrospective study of a prospectively maintained database was performed. Consecutive patients treated with CRS + HIPEC for PMP of appendiceal origin were included (September-2013 to December-2021). Pathological features of the peritoneal disease were used to classify patients into the four groups proposed by PSOGI. Survival analysis was performed to evaluate the correlation of pathology on overall survival (OS) and disease-free survival (DFS).

Results: Overall, 104 patients were identified; 29.6 % were reclassified as acellular mucin (AM), 43.9 % as low-grade mucinous carcinoma peritonei (LGMCP), 22.4 % as high-grade MCP (HGMCP) and 4.1 % as HGMCP with signet ring cells (HGMCP-SRC). Median PCI and rate of optimal cytoreduction were 19 and 82.7 %, respectively. Median OS and DFS were not reached, 5-year OS and DFS were 88.6(SD 0.04) % and 61.6(SD 0.06) %, respectively. Log-Rank test revealed significant differences in terms of OS and DFS across the different histological subgroups (p<0.001 in both cases). However, histology did not retain its significance in the multivariate analysis for OS or DFS (p=0.932 and p=0.872, respectively).

Conclusions: Survival outcomes after CRS + HIPEC for PMP are excellent. The PSOGI pathological classification correlates with OS and DFS, but differences were not significant at multivariate analysis when adjusted for other prognostic factors.

目的:国际腹膜表面肿瘤组织(PSOGI)共识根据组织病理特征将腹膜假性黏液瘤(PMP)细分为四组。本文的目的是报告来自国家转诊中心的细胞减少手术(CRS)和腹腔热化疗(HIPEC)后的生存结果,并将PSOGI分类与生存联系起来。方法:对前瞻性维护的数据库进行回顾性研究。纳入连续接受CRS + HIPEC治疗阑尾源性PMP的患者(2013年9月至2021年12月)。根据腹膜疾病的病理特征将患者分为PSOGI提出的四组。进行生存分析,评估病理与总生存期(OS)和无病生存期(DFS)的相关性。结果:共发现104例患者;29.6% %为脱细胞粘蛋白(AM), 43.9% %为低级别黏液性腹膜癌(LGMCP), 22.4% %为高级别MCP (HGMCP), 4.1% %为伴印戒细胞的HGMCP (HGMCP- src)。中位PCI和最佳细胞减数率分别为19%和82.7 %。未达到中位OS和DFS, 5年OS和DFS分别为88.6(SD 0.04) %和61.6(SD 0.06) %。Log-Rank检验显示,不同组织学亚组的OS和DFS存在显著差异(结论:CRS + HIPEC治疗PMP后的生存结果非常好。PSOGI病理分类与OS和DFS相关,但在校正其他预后因素后,多因素分析差异无统计学意义。
{"title":"Correlation between PSOGI pathological classification and survival outcomes of patients with pseudomyxoma peritonei treated using cytoreductive surgery and HIPEC: national referral centre experience and literature review.","authors":"Lorena Martín-Román,&nbsp;Enda Hannan,&nbsp;Mohammad Faraz Khan,&nbsp;Anna Sophia Müller,&nbsp;Conor Shields,&nbsp;John Aird,&nbsp;Brendan Moran,&nbsp;Jurgen Mulsow","doi":"10.1515/pp-2023-0001","DOIUrl":"https://doi.org/10.1515/pp-2023-0001","url":null,"abstract":"<p><strong>Objectives: </strong>The Peritoneal Surface Oncology Group International (PSOGI) consensus subdivided pseudomyxoma peritonei (PMP) into four groups according to histopathological features. The aim of this paper is to report survival outcomes after cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) from a national referral centre and to correlate the PSOGI classification with survival.</p><p><strong>Methods: </strong>A retrospective study of a prospectively maintained database was performed. Consecutive patients treated with CRS + HIPEC for PMP of appendiceal origin were included (September-2013 to December-2021). Pathological features of the peritoneal disease were used to classify patients into the four groups proposed by PSOGI. Survival analysis was performed to evaluate the correlation of pathology on overall survival (OS) and disease-free survival (DFS).</p><p><strong>Results: </strong>Overall, 104 patients were identified; 29.6 % were reclassified as acellular mucin (AM), 43.9 % as low-grade mucinous carcinoma peritonei (LGMCP), 22.4 % as high-grade MCP (HGMCP) and 4.1 % as HGMCP with signet ring cells (HGMCP-SRC). Median PCI and rate of optimal cytoreduction were 19 and 82.7 %, respectively. Median OS and DFS were not reached, 5-year OS and DFS were 88.6(SD 0.04) % and 61.6(SD 0.06) %, respectively. Log-Rank test revealed significant differences in terms of OS and DFS across the different histological subgroups (p<0.001 in both cases). However, histology did not retain its significance in the multivariate analysis for OS or DFS (p=0.932 and p=0.872, respectively).</p><p><strong>Conclusions: </strong>Survival outcomes after CRS + HIPEC for PMP are excellent. The PSOGI pathological classification correlates with OS and DFS, but differences were not significant at multivariate analysis when adjusted for other prognostic factors.</p>","PeriodicalId":20231,"journal":{"name":"Pleura and Peritoneum","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10249754/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9611742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The role of cytology in patients undergoing pressurized intraperitoneal aerosol chemotherapy (PIPAC) treatment for peritoneal carcinomatosis. 细胞学在腹膜癌患者接受加压腹腔喷雾化疗(PIPAC)治疗中的作用。
IF 1.8 Q2 Medicine Pub Date : 2023-06-01 DOI: 10.1515/pp-2022-0197
Mélina Deban, Julien Châtelain, François Fasquelle, Daniel Clerc, Laura Toussaint, Martin Hübner, Hugo Teixeira Farinha

Objectives: Cytology of ascites or peritoneal washing is a routine part of staging of peritoneal metastases (PM). We aim to determine value of cytology in patients undergoing pressurized intraperitoneal aerosol chemotherapy (PIPAC).

Methods: Single-center retrospective cohort study included consecutive patients having PIPAC for PM of different primary between January 2015 and January 2020.

Results: A total of 75 patients (median 63 years (IQR 51-70), 67 % female) underwent a total of 144 PIPAC. At PIPAC 1 59 % patients had positive and 41 % patients had negative cytology. Patients with negative and positive cytology only differed in terms of symptoms of ascites (16% vs. 39 % respectively, p=0.04), median ascites volume (100 vs. 0 mL, p=0.01) and median PCI (9 vs. 19, p<0.01). Among 20 patients who completed 3 PIPACs (per protocol), cytology changed in one from positive to negative, and in two from negative to positive. Median overall survival was 30.9 months in the per protocol group and 12.9 months in patients having <3 PIPACs (=0.519).

Conclusions: Positive cytology under PIPAC treatment is more frequently encountered in patients with higher PCI and symptomatic ascites. Cytoversion was rarely observed and cytology status had no impact on treatment decisions in this cohort.

目的:腹水或腹膜冲洗细胞学检查是腹膜转移(PM)分期的常规部分。我们的目的是确定细胞学在接受加压腹腔内气溶胶化疗(PIPAC)的患者中的价值。方法:单中心回顾性队列研究,纳入2015年1月至2020年1月期间连续接受PIPAC治疗不同原发PM的患者。结果:共有75例患者(中位年龄63岁(IQR 51-70), 67% %为女性)接受了144次PIPAC。在PIPAC 1时,59 %的患者细胞学阳性,41 %的患者细胞学阴性。细胞学阴性和阳性患者仅在腹水症状(分别为16% vs. 39% %,p=0.04)、腹水中位体积(100 vs. mL, p=0.01)和PCI中位(9 vs. 19, p)方面存在差异。结论:PIPAC治疗下细胞学阳性更常出现在PCI较高且有症状的腹水患者中。在这个队列中,很少观察到细胞版本,细胞学状态对治疗决策没有影响。
{"title":"The role of cytology in patients undergoing pressurized intraperitoneal aerosol chemotherapy (PIPAC) treatment for peritoneal carcinomatosis.","authors":"Mélina Deban,&nbsp;Julien Châtelain,&nbsp;François Fasquelle,&nbsp;Daniel Clerc,&nbsp;Laura Toussaint,&nbsp;Martin Hübner,&nbsp;Hugo Teixeira Farinha","doi":"10.1515/pp-2022-0197","DOIUrl":"https://doi.org/10.1515/pp-2022-0197","url":null,"abstract":"<p><strong>Objectives: </strong>Cytology of ascites or peritoneal washing is a routine part of staging of peritoneal metastases (PM). We aim to determine value of cytology in patients undergoing pressurized intraperitoneal aerosol chemotherapy (PIPAC).</p><p><strong>Methods: </strong>Single-center retrospective cohort study included consecutive patients having PIPAC for PM of different primary between January 2015 and January 2020.</p><p><strong>Results: </strong>A total of 75 patients (median 63 years (IQR 51-70), 67 % female) underwent a total of 144 PIPAC. At PIPAC 1 59 % patients had positive and 41 % patients had negative cytology. Patients with negative and positive cytology only differed in terms of symptoms of ascites (16% vs. 39 % respectively, p=0.04), median ascites volume (100 vs. 0 mL, p=0.01) and median PCI (9 vs. 19, p<0.01). Among 20 patients who completed 3 PIPACs (per protocol), cytology changed in one from positive to negative, and in two from negative to positive. Median overall survival was 30.9 months in the per protocol group and 12.9 months in patients having <3 PIPACs (=0.519).</p><p><strong>Conclusions: </strong>Positive cytology under PIPAC treatment is more frequently encountered in patients with higher PCI and symptomatic ascites. Cytoversion was rarely observed and cytology status had no impact on treatment decisions in this cohort.</p>","PeriodicalId":20231,"journal":{"name":"Pleura and Peritoneum","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10249751/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9611743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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Pleura and Peritoneum
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