Background: The surgical management of peritoneal metastases from colorectal cancer has been a topic of controversial discussion for many decades. Peritonectomy and perioperative intraperitoneal chemotherapy added options for surgical treatment of this condition beyond palliative surgery. The most favorable outcomes are recorded when peritoneal metastases from colorectal cancer can be resected to no visible evidence of disease. Methods: To determine if any benefit from surgical treatment of patients with colorectal peritoneal metastases can occur from incomplete resection of peritoneal metastases, we studied patients by the completeness of cytoreduction (CC) score. The CC-3 indicated a palliative resection, CC-2 gross residual disease, and CC-1 almost complete cytoreduction but visible residual disease. The impact of clinical-, pathologic-, and treatment-related variables on the survival of the three groups was compared. Results: Eighty-five patients with long-term follow-up were available for study. The median age was 53 years (range 18–82). There were 60 males (70.6%). Symptomatic patients, those with bowel obstruction, and patients with positive retroperitoneal lymph nodes had significantly reduced survival. The median survival of the CC-3, CC-2, and CC-1 groups were significantly different (p = 0.0027). The 2-year or greater survivals of the three groups were 4.8%, 15.1%, and 38.7%, respectively. Conclusions: If a near complete cytoreduction combined with hyperthermic intraperitoneal chemotherapy can be performed, short-term survival benefit could be observed.
Visc Med

中文翻译：

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结直肠癌腹膜转移瘤的不完全减瘤：减瘤评分的生存结果

背景：几十年来，结直肠癌腹膜转移瘤的手术治疗一直是一个有争议的话题。除了姑息性手术之外，腹膜切除术和围手术期腹膜内化疗增加了手术治疗这种情况的选择。当结直肠癌的腹膜转移灶可以切除到没有明显的疾病证据时，记录最有利的结果。方法：为了确定腹膜转移灶切除不完全是否可以从结直肠腹膜转移瘤患者的手术治疗中获益，我们通过细胞减灭术 (CC) 评分对患者进行了研究。CC-3 表示姑息性切除，CC-2 大体残留病灶，CC-1 几乎完全减细胞但可见残留病灶。比较了临床、病理和治疗相关变量对三组生存率的影响。结果：85 名接受长期随访的患者可供研究。中位年龄为 53 岁（范围 18-82）。男性 60 人（70.6%）。有症状的患者、肠梗阻患者和腹膜后淋巴结阳性患者的生存率显着降低。CC-3、CC-2 和 CC-1 组的中位生存期有显着差异（p = 0.0027）。三组的 2 年或更长时间生存率分别为 4.8%、15.1% 和 38.7%。结论：如果可以进行接近完全的细胞减灭术并结合腹腔热灌注化疗，可以观察到短期生存获益。
粘性医学