年轻结直肠癌腹膜转移病人行细胞减灭术联合腹腔热灌注化疗的有效性分析

doi:10.3969/j.issn.1005-6483.20250326

临床外科杂志 ›› 2026, Vol. 34 ›› Issue (5): 550-555.doi: 10.3969/j.issn.1005-6483.20250326

年轻结直肠癌腹膜转移病人行细胞减灭术联合腹腔热灌注化疗的有效性分析

100021 北京，国家癌症中心/国家肿瘤临床医学研究中心/中国医学科学院北京协和医学院肿瘤医院结直肠外科（侯文、于洪霞、潘雨婷、云红）；中国医学科学院北京协和医学院/国家心血管病中心/中国医学科学院阜外医院成人外科中心（段佳丽）

收稿日期:2025-04-02 接受日期:2025-04-02 出版日期:2026-05-20 发布日期:2026-05-20
通讯作者: 云红，Email：Yunhong0220@163.com
基金资助:
中国癌症基金会北京希望马拉松专项基金资助项目（LC2022L01）

Efficacy analysis of cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy in young patients with peritoneal metastasis of colorectal cancer

Department of Colorectal Surgery,National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100021,China

Received:2025-04-02 Accepted:2025-04-02 Online:2026-05-20 Published:2026-05-20

摘要/Abstract

摘要： 目的探讨年轻结直肠癌腹膜转移病人能否通过细胞减灭术（CRS）联合腹腔热灌注化疗（HIPEC）取得生存获益。方法 2019年6月~2023年6月接受CRS联合HIPEC的结直肠癌腹膜转移病人140例，观察围手术期结局与生存结果。根据年龄将病人分为年轻组（年龄≤50岁）与非年轻组（年龄>50岁）。采用Kaplan-Meier法绘制生存曲线，组间生存差异采用logrank进行比较。研究终点为3年肿瘤特异性生存率（CSS）。结果 140例病人中，年轻组46例，非年轻组94例。年轻组病人相比于非年轻组病人更易出现腹膜转移（78.3% 比 51.1%），且年轻组病人组织学类型为黏液腺癌/印戒细胞癌的比例显著高于非年轻组（29.8% 比 60.9%），差异有统计学意义（P<0.05）。两组病人的3年CSS相似（51.4% 比 35.9%）。多因素Cox回归分析显示，黏液腺癌/印戒细胞癌（HR=2.22,95%CI:1.06~4.75;P=0.043）与直肠起源（HR=2.54,95%CI:1.14~5.70;P=0.023）是不良CSS的独立危险因素。结论年轻结直肠癌腹膜转移病人更倾向于出现同时性腹膜转移。虽然年轻病人表现出较强的肿瘤侵袭性与不良组织学类型，但仍可通过CRS联合HIPEC取得与非年轻病人相似的生存获益。

关键词: 结直肠癌, 腹膜转移, 细胞减灭术, 腹腔热灌注化疗, 预后, 年轻

Abstract: Objective To explore whether young patients with peritoneal metastasis of colorectal cancer can achieve survival benefits through cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC).Methods From June 2019 to June 2023,140 patients with peritoneal metastasis of colorectal cancer who received CRS combined with HIPEC were included.The perioperative outcomes and survival results were observed.The patients were divided into the young group (age ≤50 years old) and the non-young group (age >50 years old) according to their age.Survival curves were plotted using the Kaplan-Meier method,and survival differences between groups were compared using logrank.The endpoint of the study was 3-year tumor-specific survival rate (CSS).Results Among the 140 patients,there were 46 cases in the young group and 94 cases in the non-young group.Patients in the young group were more prone to peritoneal metastasis than those in the non-young group (78.3% vs.51.1%),and the proportion of patients with histological type of mucinous adenocarcinoma/signet ring cell carcinoma in the young group was significantly higher than that in the non-young group (29.8% vs.60.9%),and the difference was statistically significant (P<0.05).The 3-year CSS of the two groups of patients was similar (51.4% vs.35.9%).Multi-factor Cox regression analysis showed that mucous adenocarcinoma/signet ring cell carcinoma (HR:2.22,95%CI:1.06~4.75;P=0.043) and rectal origin (HR:2.54,95%CI:1.14~5.70;P=0.023) are independent risk factors for adverse CSS.Conclusion Young patients with peritoneal metastasis of colorectal cancer are more likely to have synchronous peritoneal metastasis.Although young patients show stronger tumor invasiveness and poor histological types,they can still achieve similar survival benefits to non-young patients through CRS combined with HIPEC.

Key words: colorectal cancer, peritoneal metastasis, cytoreductive surgery, hyperthermic intraperitoneal chemotherapy, prognosis, younger

侯文于洪霞潘雨婷段佳丽云红. 年轻结直肠癌腹膜转移病人行细胞减灭术联合腹腔热灌注化疗的有效性分析[J]. 临床外科杂志, 2026, 34(5): 550-555.

HOU Wen, YU Hongxia, PAN Yuting, DUAN Jiali, YUN Hong. Efficacy analysis of cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy in young patients with peritoneal metastasis of colorectal cancer[J]. JOURNAL OF CLINICAL SURGERY, 2026, 34(5): 550-555.

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年轻结直肠癌腹膜转移病人行细胞减灭术联合腹腔热灌注化疗的有效性分析

Efficacy analysis of cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy in young patients with peritoneal metastasis of colorectal cancer

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