腹膜转移的结肠癌患者MDT诊治二例

本文描述了2例异时性腹膜转移的结肠癌病例的多学科诊治过程。1例多发转移，1例单发转移。这两例患者经MDT讨论后都首先采用了肿瘤减灭术联合腹腔热灌注化疗的治疗模式（cytoreductive surgery，CRS/hyperthermic intraperitoneal peroperative chemotherapy，HIPEC），单发转移的患者目前获得了12个月的无病生存期（disease-free survival，DFS），而多发转移的患者也获得了12个多月的总生存期（overall survival，OS）。目前发现与结直肠癌腹膜转移患者OS相关的因素包括肿瘤减灭术（CRS）完全程度和肿瘤累及的范围（腹膜转移癌指数）等。因此，对于结直肠癌的腹膜转移患者，评估病变范围极其重要，对于较局限的腹膜转移，多学科的综合诊治和积极的治疗手段能改善这部分患者的生存时间和生存质量。

Two case reports of colon cancer peritoneal metastases treated by multidisciplinary team

This article describes that 2 cases of heterochronic colon cancer peritoneal metastases were treated by multidisciplinary team (MDT). One case was colon cancer with multiple metastases, and the other case was single metastasis. After MDT discussion both patients were underwent cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy (CRS/HIPEC), the patient with single metastasis obtained the DFS of 16 months, and multiple metastases patient achieved more than 16 months of OS. Currently some study revealed that the OS of colorectal cancer patients with peritoneal metastases was associated with completeness of cytoreduction (CC), the disease burden (peritoneal cancer index, PCI), etc. Therefore, for patients with peritoneal metastasis of colorectal cancer, assessmemt of the extent of metastases is extremely important, if peritoneal metastasis is relatively limited, multi-disciplinary comprehensive treatment, and radical treatment approach may improve these patient′s overall survival and quality of life.