Horvath Philipp, Yurttas Can, Baur Isabella, Steidle Christoph, Reymond Marc André, Girotti Paolo Nicola Camillo, Königsrainer Alfred, Königsrainer Ingmar
Department of General, Visceral and Transplant Surgery, University Hospital Tübingen, Hoppe-Seyler-Str. 3, D-72076 Tübingen, Germany.
Department of General, Visceral and Thoracic Surgery, Academic Teaching Hospital Feldkirch, Carinagasse 47, 6807 Feldkirch, Austria.
Cancers (Basel). 2022 Mar 11;14(6):1443. doi: 10.3390/cancers14061443.
Tailored approaches in gastrointestinal oncology have been more frequently introduced in past years and for patients with peritoneal metastases. This article attempts to overview the current strategies in surgical gastrointestinal oncology, with a focus on gastrointestinal peritoneal metastases.
In 2019, all patients undergoing PIPAC therapy in Germany were retrospectively analyzed regarding morbidity and in-hospital mortality rates. Furthermore, patients with chemotherapy-refractory peritoneal metastases from gastric cancer undergoing PIPAC-therapy at our institution were analyzed.
In 2019, 534 patients received PIPAC treatment in german hospitals. The in-hospital mortality rate was 0%. In total, 36 patients suffered from postoperative complications (8%). From April 2016 to September 2021, a total of 44 patients underwent 93 PIPAC applications at our institution. The non-access-rate was 0%. The median PRGS was two (range, 1-4). Eleven patients (44%) showed histologically stable disease, whereas six patients (24%) showed histological regression. Median survival, calculated from the date of the first PIPAC application, was 181 days (range, 43-636 days).
PIPAC is a safe and feasible procedure with a low in-hospital morbidity and mortality. Furthermore, PIPAC in the palliative and chemorefractory setting and is an appealing approach for patient management in the future.
在过去几年中,针对胃肠道肿瘤的个体化治疗方法被更频繁地引入,尤其是针对有腹膜转移的患者。本文旨在概述外科胃肠道肿瘤学的当前策略,重点关注胃肠道腹膜转移。
对2019年在德国接受腹腔热灌注化疗(PIPAC)治疗的所有患者的发病率和住院死亡率进行回顾性分析。此外,还对在我们机构接受PIPAC治疗的化疗难治性胃癌腹膜转移患者进行了分析。
2019年,德国医院有534例患者接受了PIPAC治疗。住院死亡率为0%。共有36例患者出现术后并发症(8%)。从2016年4月到2021年9月,我们机构共有44例患者接受了93次PIPAC治疗。未进入率为0%。PRGS中位数为2(范围1 - 4)。11例患者(44%)组织学上疾病稳定,而6例患者(24%)组织学上有消退。从首次PIPAC治疗日期开始计算,中位生存期为181天(范围43 - 636天)。
PIPAC是一种安全可行的手术,住院发病率和死亡率较低。此外,PIPAC在姑息和化疗难治性情况下是未来患者管理的一种有吸引力的方法。