| Guangcai Niu,Xiangdong Ma. Peritoneal cancer index is a prognostic indicator of survival in advanced gastric cancer with peritoneal carcinomatosis. Oncol Transl Med, 2020, 6: 116-120. |
| 腹膜转移指数是晚期胃癌合并腹膜转移患者生存的预后指标 |
| Peritoneal cancer index is a prognostic indicator of survival in advanced gastric cancer with peritoneal carcinomatosis |
| Received:September 04, 2019 Revised:June 17, 2020 |
| DOI：10.1007/s10330-019-0381-1 |
| 中文关键词: 腹膜转移指数，晚期胃癌，腹膜转移，生存时间，并发症 |
| 英文关键词: peritoneal cancer index (PCI); advanced gastric cancer (AGC); peritoneal carcinomatosis (PC); survival; complication |
| 基金项目: |
| Author Name | Affiliation | Postcode | | Guangcai Niu | Department of Oncological Surgery, Xuzhou Central Hospital | 221009 | | Xiangdong Ma* | Department of Oncological Surgery, Xuzhou Central Hospital | 221009 |
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| 中文摘要: |
| 目的:应用腹膜转移指数(PCI)已经用于对妇科原发肿瘤的腹膜播散情况的具体评估，并且可作为预测生存的重要指标。本研究旨在探讨腹膜转移指数在晚期胃癌(AGC)合并腹膜转移(PC)患者中的意义。
病人和方法:从2010年到2018年的回顾性分析60 AGC PC患者,其中21病人PCI≤13，39个病人PCI > 13。所有患者均行手术及术中腹腔灌注化疗(IPHC)。对患者的一般情况(Karnofsky performance status)、年龄、性别、Borromann的分级、分化、浸润深度(T)、淋巴结转移(N)、腹膜转移指数、胃切除程度、淋巴结清扫程度、残余肿瘤等进行回顾性研究，并与生存分析。
结果:5年总生存率为43%，平均生存时间为54.47+4.53个月。单因素分析显示，Borromann的分级、分化、浸润深度、腹膜转移指数、残余肿瘤体积小是预后良好的临床指标(p<0.05)。Cox比例回归危险模型显示，只有残余肿瘤体积和腹膜转移指数与术后生存相关。PCI≤13患者平均生存时间是69.76个月，PCI > 13患者的平均生存时间是39.96个月。两组患者生存率差异有统计学意义(p = 0.004)。PCI≤13组术后主要并发症的发生率和死亡率分别为4.76%和23.81，PCI > 13组的分别为5.12%和43.59。
结论:利用腹膜转移指数可较详细地评价晚期胃癌合并腹膜转移的具体播散情况。同事也是一个重要的预后生存因素，并有助于确定哪些亚组病人手术可获益。 |
| 英文摘要: |
| Objective The peritoneal cancer index (PCI) has been used for the detailed evaluation of the peritoneal
spread in tumors of a gynecologic origin and has been found to be a prognostic indicator of survival. The
aim of this study was to identify the significance of the PCI in advanced gastric cancer (AGC) with peritoneal
carcinomatosis (PC).
Methods From 2010 to 2018, a retrospective analysis was carried out of 60 AGC patients with PC,
including 21 patients with a PCI ≤ 13 and 39 with a PCI > 13. All patients were treated with both surgery
and intraoperative peritoneal hyperthermic chemotherapy (IPHC). The performance status (Karnofsky
performance status), age, sex, Borromann’s classification, differentiation, depth of invasion, lymph node
metastasis, PCI, extent of gastrectomy, extent of lymph node dissection, and residual tumor volume were
retrospectively evaluated and correlated to survival.
Results The overall 5-year survival rate was 43% and mean survival was (54.47 ± 4.53) months. The
favorable clinical prognostic indicators of survival were Borromann’s classification, differentiation, depth
of invasion, PCI, and residual tumor volume on univariate analyses (P < 0.05). The Cox proportional
regression hazard model showed that only the volume of residual tumor and PCI were associated with
postoperative survival. The median survival time was 69.76 months for patients with a PCI ≤ 13 and 39.96
months for patients with a PCI > 13. There was a significant difference in survival rate between the two
group (P = 0.004). Postoperative major morbidity and mortality rates were 23.81% and 4.76% in the PCI ≤
13 group and 43.59% and 5.12% in the PCI > 13 group, respectively.
Conclusion The peritoneal spread in advanced gastric cancer with peritoneal carcinomatosis can
be assessed in detail using the PCI. It is also a significant prognostic factor of survival and is useful in
identifying subgroups. |
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