Multidisciplinary treatment of colorectal cancer peritoneal metastasis

蔡国响; 孟献珂; 蔡三军

doi:10.3969/j.issn.1007-3969.2015.11.008

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Multidisciplinary treatment of colorectal cancer peritoneal metastasis

更新时间：2025-12-31

- Multidisciplinary treatment of colorectal cancer peritoneal metastasis
- China Oncology Vol. 25, Issue 11, Pages: 890-894(2015)
- 作者机构：
  
  复旦大学附属肿瘤医院大肠外科，复旦大学上海医学院肿瘤学系,上海,200032
- 作者简介：
- 基金信息：
- DOI：10.3969/j.issn.1007-3969.2015.11.008
  CLC：
- Published Online：01 February 2016，
  
  Published：01 February 2015
- 稿件说明：
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蔡国响,孟献珂,蔡三军. 结直肠癌腹膜转移的多学科综合治疗[J]. 中国癌症杂志, 2015, 25(11): 890-894.

蔡国响, 孟献珂, 蔡三军. Multidisciplinary treatment of colorectal cancer peritoneal metastasis[J]. China Oncology, 2015, 25(11): 890-894.
蔡国响,孟献珂,蔡三军. 结直肠癌腹膜转移的多学科综合治疗[J]. 中国癌症杂志, 2015, 25(11): 890-894. DOI： 10.3969/j.issn.1007-3969.2015.11.008.

蔡国响, 孟献珂, 蔡三军. Multidisciplinary treatment of colorectal cancer peritoneal metastasis[J]. China Oncology, 2015, 25(11): 890-894. DOI： 10.3969/j.issn.1007-3969.2015.11.008.

摘要

腹膜转移是结直肠癌常见转移部位之一，传统观念认为其预后差，没有手术治疗的价值。近年来，随着外科技术、精确控温的腹腔热灌注化疗以及多学科综合治疗的进步，对结直肠癌腹膜转移的认识和治疗策略发生很大的变化，拟就这一问题进行综述。在预后方面，如果仅行姑息性化疗，结直肠癌腹膜转移的预后差于肝、肺等非腹膜部位的转移；但对于一部分合适的患者施行完全性腹膜减瘤术联合腹腔热灌注化疗，则可能使部分患者获得长期生存；腹膜转移癌的预后因素包括腹膜播散癌指数、减瘤术完全性程度、是否合并腹膜外转移(肝脏等)、腹膜表面疾病严重程度评分和日本腹膜分期等。在治疗方面，完全性腹膜减瘤术联合腹腔热灌注化疗以及全身治疗(化疗+靶向治疗)，可能是最佳的多学科综合治疗策略。

Abstract

Peritoneum is one of the common site of colorectal cancer metastasis. Traditionally

peritoneal carcinomatosis is associated with a poor prognosis without effective surgical treatment. Recently

the attitude towards the treatment strategies for colorectal peritoneal metastasis has changed significantly with advances in surgical techniques

hyperthermic intraperitoneal chemotherapy and multi-disciplinary treatment. As to the prognosis

colorectal peritoneal metastasis has an inferior outcome to non-peritoneal metastasis under the palliative systemic treatment. However

the complete peritoneal cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy can achieve a long-term survival in selective patients with colorectal peritoneal metastasas. The prognostic factors include peritoneal carcinomatosis index

completeness of cytoreduction

the presence of extra-peritoneal metastasis (liver etc)

peritoneal surface disease severity score and Japanese peritoneal staging. In terms of the treatment

complete peritoneal cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy and systemic treatment (including chemotherapy and targeted therapy) may be the best modality of multi-disciplinary treatment for colorectal peritoneal metastasis.

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