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1.
Background Cytoreductive surgery combined with perioperative intraperitoneal chemotherapy has been suggested as a treatment option for
patients with colorectal peritoneal carcinomatosis. However, the survival benefit is achieved at the expense of moderate to
high perioperative morbidity and mortality.
Methods This review summarized the important prognostic factors for survival; outlined the patient selection process from major peritonectomy
centers, paying particular attention to preoperative evaluation; and identified areas for potential improvement. Emphasis
was placed on a strict patient selection process to avoid futile aggressive treatments.
Results Currently, contrast-enhanced computed tomography, magnetic resonance imaging, positron emission tomography, and laparoscopy
have been utilized in the preoperative evaluation process to identify potential surgical candidates. Patients with good performance
status, low volume of peritoneal disease, and absence of extra-abdominal metastases are more likely to benefit from the combined
treatment.
Conclusions Quantitative assessment of the extent of disease is possible and should be performed at the time of primary cancer operation.
Careful selection of patients to identify surgical candidates with favorable prognostic indicators is important. 相似文献
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Background
Cytoreductive surgery (CRS) combined with perioperative intraperitoneal chemotherapy (PIC) has demonstrated improved survival in selected patients with colorectal peritoneal carcinomatosis (CRPC). This treatment modality is associated with relatively high rates of perioperative morbidity and mortality. This study evaluated the clinical and treatment-related risk factors for perioperative morbidity and mortality in patients with CRPC who underwent CRS and PIC. 相似文献4.
Cytoreductive Surgery and Intraperitoneal Hyperthermic Chemotherapy With Mitomycin C for Peritoneal Carcinomatosis from Nonappendiceal Colorectal Carcinoma 总被引:11,自引:7,他引:11
Shen P Hawksworth J Lovato J Loggie BW Geisinger KR Fleming RA Levine EA 《Annals of surgical oncology》2004,11(2):178-186
Background: Cytoreductive surgery (CS) and intraperitoneal hyperthermic chemotherapy (IPHC) are efficacious in patients with disseminated mucinous tumors of the appendix. We reviewed our experience using this approach for nonappendiceal colorectal cancer (NACC).Methods: We performed a retrospective chart review of a prospective database for patients undergoing CS and IPHC with mitomycin C for peritoneal carcinomatosis from colorectal primary lesions between December 1991 and April 2002.Results: There were 77 patients, with a median age of 54 years. Peritoneal carcinomatosis was synchronous and metachronous in 27% and 73% patients, respectively. Seventy-five percent of patients (n = 58) had received chemotherapy prior to IPHC. Complete resection of all gross disease was accomplished in 37 patients (48%). The mean carcinoembryonic antigen level decreased from a preoperative value of 31.2 to a postoperative value of 6.9 (P < .0001). Overall survival (OS) at 1, 3, and 5 years was 56%, 25%, and 17%, respectively. With a median follow-up of 15 months, the median OS was 16 months. Perioperative morbidity and mortality were 30% and 12%, respectively. Hematologic toxicity occurred in 15 patients (19%). Cox regression analysis identified poor performance status (P = .018), bowel obstruction (P = .001), malignant ascites (P = .001), and incomplete resection of gross disease (P = .011) as independent predictors of decreased survival. Patients with complete resection of all gross disease had a 5-year OS of 34%, with a median OS of 28 months.Conclusions: CS and IPHC with mitomycin C can improve outcomes for select patients with peritoneal spread from NACC. One third of patients who undergo complete resection of gross disease have long-term survival. 相似文献
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Comparison of Two Kinds of Intraperitoneal Chemotherapy Following Complete Cytoreductive Surgery of Colorectal Peritoneal Carcinomatosis 总被引:1,自引:0,他引:1
Elias D Benizri E Di Pietrantonio D Menegon P Malka D Raynard B 《Annals of surgical oncology》2007,14(2):509-514
Background Recently, the combination of complete cytoreductive surgery followed immediately by intraperitoneal chemotherapy achieved
cure in some patients suffering from peritoneal carcinomatosis (PC). It is now well established that the prognostic impact
of the completeness of cytoreduction is high. However, two different modes of intraperitoneal chemotherapy are proposed: early
postoperative intraperitoneal chemotherapy (EPIC), which lasts for 5 days and is normothermic, and peroperative intraperitoneal
chemohyperthermia (IPCH). To date, the results of these procedures have never been compared.
Aim of the study To compare the complications and therapeutic results of EPIC and IPCH after complete cytoreductive surgery of colorectal PC.
Materials and methods Twenty-three consecutive patients with colorectal PC were selected based on the completeness of cytoreductive surgery and
sufficient follow-up. They received IPCH with oxaliplatin (460 mg/m2) in 2 l/m2 of dextrose, for 30 min at an intraperitoneal
temperature of 43°C, using the coliseum technique. We retrospectively carefully selected another 23 patients, for comparison
purposes, suffering from the same disease, with characteristics as similar as possible, but treated earlier with EPIC (mitomycin
C 10 mg/m2 at day 0 and 5-FU 650 mg/m2 from days 1 to 4), in 1 l/m2 of ringer lactate. Data concerning these two groups were
verified prospectively, but this study was a comparative historical analysis.
Results The two groups were statistically comparable, except for the duration of surgery which was 68 min longer for the IPCH group.
Mortality and morbidity were not significantly different, even if two deaths occurred in the EPIC group, and none in the IPCH
group. However, the rate of digestive fistulas was higher (P = 0.02) in the EPIC group (26%) than in the IPCH group (0%). Overall survival (OS) was higher in the IPCH group, (54% at
5 years vs. 28% for EPIC), but not significantly (P = 0.22). Peritoneal carcinomatosis recurred much (P = 0.03) more frequently in the EPIC group (57%) than in the IPCH-group (26%).
Conclusion This study provides strong arguments indicating that IPCH with oxaliplatin is better tolerated than EPIC with mitomycin C
and 5-FU, and is twice as efficient in curing residual peritoneal carcinomatosis measuring less than 1 mm. 相似文献
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Konstantinos I. Votanopoulos MD Katrina Swett MS Aaron U. Blackham MD Chukwuemeka Ihemelandu MD Perry Shen MD John H. Stewart MD Edward A. Levine MD 《Annals of surgical oncology》2013,20(4):1088-1092
Background
Cytoreductive surgery (CS) with hyperthermic intraperitoneal chemotherapy (HIPEC) is the treatment most likely to achieve prolonged survival in peritoneal carcinomatosis (PC). Yet the efficacy of HIPEC in rectal patients is controversial because of the retroperitoneal location of the primary tumor. Therefore, we reviewed our experience in patients with PC from a rectal primary tumor.Methods
A retrospective analysis of a prospective database of 950 HIPEC procedures was performed. Performance status, age, albumin level, prior surgical score, resection status, morbidity, mortality, and survival were reviewed.Results
A total of 13 and 204 patients with PC from rectal and colon cancer, respectively, were identified. Median follow-up was 40.1 and 88.1 months, respectively. Eastern Cooperative Oncology Group (ECOG) score was zero or one for 92 % of patients with rectal cancer and 83 % for colon, while R1 resection was achieved in 54 and 51 %. The 30-day mortality was 5 % for colon cancer. There were no deaths in the rectal group. The morbidity for the colon and rectal groups was 57 and 46 %, respectively, with a 23 % 30-day readmission rate. In univariate analysis, age, ECOG, prior surgical score, albumin level, and node and resection status were not statistically significant in predicting survival for the rectal cancer patients. Median survival for the rectal and colon groups was 14.6 versus 17.3 months, while the 3-year survival was 28.2 versus 25.1 %.Conclusions
Our data demonstrate similar 3-year survival for patients with rectal and colon cancer PC treated with CS/HIPEC. This can be attributed to patient selection bias. Selected rectal cancer PC patients should not be excluded from an attempted cytoreduction and HIPEC. 相似文献7.
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McQuellon RP Danhauer SC Russell GB Shen P Fenstermaker J Stewart JH Levine EA 《Annals of surgical oncology》2007,14(3):1105-1113
Background Cytoreductive surgery with intraperitoneal hyperthermic chemotherapy for peritoneal carcinomitosis (PC) is an aggressive treatment
designed to alleviate symptoms and prolong life. It is associated with physical and psychological morbidity. The purpose of
this study was to monitor health outcomes related to treatment.
Methods Patients completed a questionnaire before and after surgery at 3, 6 and 12 months. The questionnaire consisted of basic demographic
items as well as the Functional Assessment of Cancer Therapy–Colon Scale (FACT-C), SF-36 Medical Outcomes Study Health Survey,
Center for Epidemiologic Studies–Depression Scale (CES-D), Brief Pain Inventory–Short Form, and ECOG Performance Status Rating.
Time trends were assessed with mixed models (SAS PROC MIXED) so as to use all data and to account for missing data.
Results Ninety-six patients (49% females, 9% African Americans) of an average age of 52.9 (SD = 12.5) years were assessed before surgery.
PC originated in primary lesions of the appendix (n = 36); colon/rectum (n = 24); mesothelium (n = 9); ovary (n = 5); stomach (n = 4); and miscellaneous (n = 18). Quality of life (QOL) and pain scores improved from baseline to 12 months. Physical functioning changed over the 12-month
study period with improvement recorded at 6 months. The percentage of patients reporting significant depressive symptom at
each time point was; baseline= 32%; 3 months= 19%; 6 & 12 months= 24%.
Conclusions Acceptable QOL, return of functional status, and reduced pain can be attained between 3 and 6 months following treatment although
some deficits in general health remain. Depressive symptoms are common and should be monitored. 相似文献
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Hill AR McQuellon RP Russell GB Shen P Stewart JH Levine EA 《Annals of surgical oncology》2011,18(13):3673-3679
Background
Peritoneal carcinomatosis of colonic origin (PCC) is a life-threatening diagnosis. Cytoreductive surgery (CS) with hyperthermic intraperitoneal chemotherapy (HIPEC) offers patients the prospect of long-term survival with alleviation of symptoms. 相似文献12.
Pompiliu Piso Przemyslaw Slowik Felix Popp Marc Hendrik Dahlke Gabriel Glockzin Hans Juergen Schlitt 《Annals of surgical oncology》2009,16(8):2188-2194
Background Cytoreductive surgery (CRS) including gastric resection combined with hyperthermic intraperitoneal chemotherapy (HIPEC) can
improve the prognosis of selected patients with peritoneal surface malignancies. Perioperative morbidity of this aggressive
treatment strategy is high; however, overall mortality can be low in specialized centers. The aim of this study was to assess
the safety of gastric resections with anastomosis during CRS and HIPEC.
Methods Between 2005 and 2008, 204 patients underwent CRS and HIPEC at our tertiary referral centre. Of these, 37 procedures (male/female
24/13, median age 55 years) included gastric resections. The clinical data of all patients were introduced into a database
and analyzed with respect to the morbidity associated with the gastric resections.
Results Of all patients included, 16 had pseudomyxoma peritonei, 11 gastric carcinoma, 4 ovarian carcinoma, 3 malignant peritoneal
mesothelioma, and 3 colon carcinoma. Twenty-seven patients had previous surgery (n = 22) and/or systemic chemotherapy (n = 18). Fifteen total gastrectomies, 3 subtotal gastrectomies, 12 distal gastrectomies, and 7 gastric wedge resections were
performed during CRS. The overall postoperative morbidity was 45%; main surgical complications were pancreatitis (n = 6), abdominal abscess (n = 4), bile leakage (n = 2), and digestive fistula (leakage of ileorectostomy and small bowel perforation) (n = 2). However, no complications occurred at the site of the esophageal anastomosis (n = 15), gastric anastomosis (n = 15) or gastric suture (n = 7). No patient died postoperatively during the hospitalization period.
Conclusions CRS in combination with HIPEC is associated with high postoperative morbidity; however, anastomosis following total or subtotal
gastrectomy is safe in experienced centers. No leakages related to gastric resections occurred in this high-risk patient group.
Pompiliu Piso and Przemyslaw Slowik have contributed equally to this study. 相似文献
13.
Clarisse Eveno MD PhD Guillaume Passot MD Diane Goéré MD PhD Philippe Soyer MD PhD Etienne Gayat MD PhD Olivier Glehen MD PhD Dominique Elias MD PhD Marc Pocard MD PhD 《Annals of surgical oncology》2014,21(6):1792-1800
Background
Patients with stage IV colorectal cancer and peritoneal carcinomatosis are increasingly treated with curative intent and perioperative systemic chemotherapy combined with targeted therapy. The aim of this study was to analyze the potential impact of bevacizumab on early morbidity after cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (HIPEC) in patients with peritoneal carcinomatosis of colorectal origin.Methods
From 2004 to 2010, in three referral centers, 182 patients with colorectal carcinomatosis were treated with complete cytoreduction followed by HIPEC after either preoperative systemic chemotherapy alone or in combination with bevacizumab. Because there was no control on treatment allocation, propensity score methods were used to control for this bias.Results
The median time from discontinuation of bevacizumab to HIPEC was 7 weeks (range 6–10 weeks). Major morbidity was greater in the bevacizumab group (34 vs. 19 %, p = 0.020). Nine patients died postoperatively, 5 (6.2 %) in the bevacizumab group (n = 80) and 4 (3.9 %) in the group treated with chemotherapy alone (n = 102) (p = 0.130). The rate of digestive fistulas was greater in the bevacizumab group, although not statistically significant (18 vs. 10 %, p = 0.300). The effect of bevacizumab on major morbidity (including death) was found to be statistically significant (odds ratio 2.28, 95 % confidence interval 1.05–4.95) (p = 0.04).Conclusions
Administration of bevacizumab before surgery with complete cytoreduction followed by HIPEC for colorectal carcinomatosis is associated with twofold increased morbidity. The oncologic benefit of bevacizumab before HIPEC remains to be evaluated. 相似文献14.
Background The efficacy of cytoreductive surgery (CRS) combined with perioperative intraperitoneal chemotherapy (PIC) for patients with
pseudomyxoma peritonei (PMP) remains to be established.
Methods Searches for all relevant studies prior to March 2006 were performed on six databases. Two reviewers independently appraised
each study using a predetermined protocol. The quality of each study was assessed. Clinical effectiveness was synthesized
through a narrative review with full tabulation of results of all included studies.
Results Ten most recent updates from each institution were included for appraisal and data extraction. There were no randomized controlled
trials or comparative studies. All included articles were observational studies without control groups. Five studies were
relatively large series (n≥100). Two studies had relatively long-term follow-up (48 months and 52 months). The median follow-up in the remaining eight
studies was shorter than 3 years (range 19–35 months). The median survival ranged from 51 to 156 months. The 1-, 2-, 3- and
5-year survival rates varied from 80 to 100%, 76 to 96%, 59 to 96% and 52 to 96%, respectively. The overall morbidity rate
varied from 33 to 56%. The overall mortality rates ranged from 0 to 18%.
Conclusions This study reviewed current evidence on CRS and PIC for PMP. Only observational studies were available for evaluation, which
demonstrated some promising long-term results, as compared to historical controls. Due to the rarity of this disease, a well-designed
prospective multi-institutional study would be meaningful. 相似文献
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Olivier Glehen MD PhD François Noel Gilly MD PhD Catherine Arvieux MD PhD Eddy Cotte MD Florent Boutitie Baudouin Mansvelt MD PhD Jean Marc Bereder MD Gérard Lorimier MD François Quenet MD Dominique Elias MD PhD 《Annals of surgical oncology》2010,17(9):2370-2377
Background
Peritoneal carcinomatosis (PC) from gastric cancer has long been regarded a terminal disease with a short median survival. New locoregional therapeutic approaches combining cytoreductive surgery with perioperative intraperitoneal chemotherapy (PIC) have evolved and suggest improved survival.Materials and Methods
A retrospective multicentric study was performed in French-speaking centers to evaluate the toxicity and the principal prognostic factors in order to identify the best indications. All patients had cytoreductive surgery and PIC: hyperthermic intraperitoneal chemotherapy (HIPEC) and/or early postoperative intraperitoneal chemotherapy (EPIC).Results
The study included 159 patients from 15 institutions between February 1989 and August 2007. The median follow-up was 20.4 months. HIPEC was the PIC used for 150 procedures. Postoperative mortality and grade 3–4 morbidity rates were 6.5 and 27.8%, respectively. By multivariate analysis, the institution had a significant influence on toxicity. The overall median survival was 9.2 months and 1-, 3-, and 5-year survival rates were 43, 18, and 13%, respectively. The only independent prognostic indicator by multivariate analysis was the completeness of cytoreductive surgery. For patients treated by complete cytoreductive surgery, the median survival was 15 months with a 1-, 3-, and 5-year survival rate of 61, 30, and 23%, respectively.Conclusions
The therapeutic approach combining cytoreductive surgery with PIC for patients with gastric carcinomatosis may achieve long-term survival in a selected group of patients (limited and resectable PC). The high mortality rate underlines this necessarily strict selection that should be reserved to experienced institutions involved in the management of PC and gastric surgery. 相似文献16.
Pilati P Mocellin S Rossi CR Foletto M Campana L Nitti D Lise M 《Annals of surgical oncology》2003,10(5):508-513
Background: Hyperthermic intraoperative intraperitoneal chemotherapy (HIIC) has been recently proposed to treat peritoneal carcinomatosis arising from colon adenocarcinoma, which is usually regarded as a lethal clinical entity. The purpose of this study was to evaluate the clinical outcome of this combined treatment.Methods: A retrospective study of 46 patients treated for peritoneal carcinomatosis from colon adenocarcinoma was performed. Thirty-four patients were treated with complete cytoreductive surgery immediately followed by intraoperative HIIC with mitomycin C and cisplatin. The clinical outcome of these 34 patients was analyzed; the median follow-up period was 14.5 months.Results: No postoperative deaths were reported. The postoperative morbidity rate was 35%. No severe locoregional or systemic toxicity was observed. The 2-year overall survival was 31%, and the median survival time and the median time to local disease progression were 18 and 13 months, respectively. Survival and local disease control in patients with well- and moderately differentiated colon adenocarcinoma were significantly better than in those with poorly differentiated tumors.Conclusions: Considering the dismal prognosis of this condition, HIIC seems to achieve encouraging results in a selected group of patients affected with resectable peritoneal carcinomatosis arising from colon adenocarcinoma. These findings support the conduction of formal phase III randomized trials. 相似文献
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David S. Sparks Bradley Morris Wen Xu Jessica Fulton Victoria Atkinson Brian Meade Nicholas Lutton 《International surgery》2015,100(1):21-28
Cytoreductive surgery (CRS) followed by hyperthermic intraperitoneal chemotherapy (HIPEC) is a radical but effective treatment option for select peritoneal malignancies. We sought to determine our early experience with this method for peritoneal carcinomatosis secondary to mucinous adenocarcinomas of appendiceal origin. As such, we performed a retrospective clinical study of 30 consecutive patients undergoing CRS with planned HIPEC at the Princess Alexandra Hospital, between June 2009 to December 2012, with mucinous adenocarcinomas of the appendix. CRS was performed in 30 patients, 13 received HIPEC intraoperatively and 17 received early postoperative intra-peritoneal chemotherapy (EPIC) in addition. Mean age was 52.3 years and median hospital stay was 26 days (range 12–190 days). Peritoneal cancer index scores were 0–10 in 6.7% of patients, 11–20 in 20% of patients and >20 in 73.3% of patients. Complete cytoreduction was achieved overall in 21 patients. In total, 106 complications were observed in 28 patients. Ten were grade 3-A, five were grade 3-B and one grade-5 secondary to a fatal PE on day 97. In patients who received HIPEC, there was no difference in disease-free survival (P = 0.098) or overall survival (P = 0.645) between those who received EPIC versus those who did not. This study demonstrates that satisfactory outcomes with regards to morbidity and survival can be achieved with CRS and HIPEC, at a single-centre institution with growing expertise in the technique. Our results are comparable with outcomes previously described in the international literature.Key words: Pseudomyxoma peritonei, Cytoreductive surgery, Heated intraperitoneal chemotherapy, Early postoperative intraperitoneal chemotherapyThe combination of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) is an effective treatment option for select peritoneal malignancies.1,2 The management centers on improving survival for a historically palliative disease. CRS aims to achieve complete tumor clearance, requiring extensive peritoneal and visceral resection. Once optimal cytoreduction is complete, HIPEC is employed intraoperatively and is selectively followed by early postoperative intraperitoneal chemotherapy (EPIC). Direct delivery into the peritoneal cavity facilitates higher regional dosing and, because of decreased systemic exposure,3 is achieved with fewer toxicities, although the role for EPIC following HIPEC remains debatable.4Such an aggressive treatment comes with significant potential morbidity; thus, appropriate patient selection is vital.5 A considerable learning curve exists.6 However, with increasing experience, an institution can significantly reduce its morbidity and mortality.7Our aim was to evaluate the outcomes early in our experience with CRS and HIPEC at the Princess Alexandra Hospital, specifically for mucinous adenocarcinoma of the appendix, and compare these outcomes with those reported in the literature globally for primary end points such as morbidity, mortality, and survival. We further sought to determine the role of HIPEC with or without EPIC because the literature remains ambivalent on this topic to date. 相似文献
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Christina Pfannenberg MD Ingmar Königsrainer MD Philip Aschoff MD Mehmet Ö. Öksüz MD Derek Zieker MD Stefan Beckert MD Stephan Symons Kay Nieselt PhD Jörg Glatzle MD Claus V. Weyhern MD Björn L. Brücher MD Claus D. Claussen MD Alfred Königsrainer MD 《Annals of surgical oncology》2009,16(5):1295-1303
Background
Cytoreductive surgery followed by hyperthermic intraperitoneal chemotherapy (HIPEC) is associated with significantly longer survival in patients with peritoneal carcinomatosis (PC). So far, no morphological imaging method has proven to accurately assess the intra-abdominal tumor spread. This study was designed to predict tumor load in patients with PC using dual-modality 18FDG-PET/CT and to compare the results with those of PET and CT alone by correlating imaging findings with intraoperative staging.Methods
Twenty-two patients with PC from gastrointestinal (n = 13), ovarian cancer (n = 8), and mesothelioma (n = 1) underwent contrast-enhanced 18FDG-PET/CT before surgery and HIPEC. In a retrospective analysis PET, CT, and fused PET/CT were separately and blindly reviewed for the extent of peritoneal involvement using the Peritoneal Cancer Index (PCI). Imaging results were correlated with the intraoperative PCI using Pearson’s correlation coefficient and linear regression analysis.Results
There was a strong correlation between the PCI obtained with PET/CT and the surgical PCI with respect to the total score (r = 0.951) as well as in the regional analysis (small bowel, r = 0.838; other, r = 0.703). The correlation was slightly lower for CT alone (total score, r = 0.919; small bowel, r = 0.754; other, r = 0.666) and significantly lower (p = 0.002) for PET alone (total score, r = 0.793; small bowel, r = 0.553, other, 0.507).Conclusions
Contrast-enhanced CT is superior compared with PET alone to predict the extent of PC. In our patient group, the combination of both modalities (contrast enhanced PET/CT) yielded the best results and proved to be a useful tool for selecting candidates for peritonectomy and HIPEC. 相似文献19.
Long-Term Survivorship and Quality of Life After Cytoreductive Surgery Plus Intraperitoneal Hyperthermic Chemotherapy for Peritoneal Carcinomatosis 总被引:15,自引:6,他引:9
McQuellon RP Loggie BW Lehman AB Russell GB Fleming RA Shen P Levine EA 《Annals of surgical oncology》2003,10(2):155-162
Background:Cytoreductive surgery plus intraperitoneal hyperthermic chemotherapy with mitomycin C for peritoneal carcinomatosis is used as a palliative treatment for a variety of malignancies. The purpose of this study was to measure the quality of life (QOL) of survivors (>3 years) after treatment.Methods:Patients were interviewed by telephone with the following tools: (1) the Functional Assessment of Cancer Therapy–Colon (FACT-C), (2) the Short Form of the Medical Outcomes Study Questionnaire, (3) the Center for Epidemiologic Studies–Depression scale, (4) the Life Appreciation scale, (5) the Psychosocial Concerns Questionnaire, and (6) performance status rating.Results:Seventeen (10 appendix, 5 large intestine, 1 ovarian, and 1 peritoneum) of 109 patients were interviewed from 3.1 to 8.0 years after treatment. Ten patients (62.5%) described their health as excellent or very good. No limitations on moderate activity were reported in 94% of cases. Paired t-tests were used to compare 10 patients who had baseline QOL data. FACT mean difference scores and P values (positive difference scores indicate improved QOL) were functional well-being: 4.9, P = .01; physical well-being: 3.3, P = .05; and FACT total: 14.3, P = .02.Conclusions:Long-term survival with good QOL is possible for selected patients with peritoneal carcinomatosis after cytoreductive surgery plus intraperitoneal hyperthermic chemotherapy. 相似文献
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Parissa Tabrizian Brian Shrager Ghalib Jibara Ming-Jim Yang Anya Romanoff Spiros Hiotis Umut Sarpel Daniel M. Labow 《Journal of gastrointestinal surgery》2014,18(5):1024-1031