本研究调查了胃癌腹膜转移 (PMGC) 患者在诱导化疗（腹腔镜 HIPEC [LHIPEC]）应答后接受转化细胞减灭手术 (C-CRS) 和术中腹腔热腹腔化疗 (HIPEC)，随后进行全身全身化疗的预测因素。 2017 年 1 月至 2022 年 12 月期间，对 62 例 PMGC 患者进行了诊断性腹腔镜检查。这些患者接受了腹腔内多西他赛 (30 mg/m2) 和顺铂 (30 mg/m2) 的 LHIPEC 和 BIC 诱导化疗（ 30 mg/m2），静脉化疗三个周期。使用 Kaplan-Meier 和 Cox 回归分析来分析无进展生存期和总生存期的预测参数。使用受试者工作特征曲线分析评估 Ki-67 参数的最佳截止值。该研究回顾性检查了 62 名对诱导治疗有反应并接受 C-CRS 或 HIPEC 的患者中的 36 名 (58%)。 Ki-67 指数低于 10 (p = 0.000)、淋巴结受累 (LNI) 低于 2 (p = 0.039) 和网膜病变大小评分低于 0.5 cm (p = 0.002) 可以预测无复发除了细胞减灭术的完整性和腹膜癌指数之外，还包括总体生存率。 Cox 回归分析显示，与无复发生存率相关的独立因素是 Ki-67 表达降低（≥10% vs <10%）（风险比 [HR] 4.7；95% 置信区间 [CI] 1.6-5.210；p = 0.020）和 LNI 高于 2（HR 1.92；95% CIS 0.923-4.0；p = 0.023）。淋巴结受累和 Ki-67 表达下降是 PMGC 患者诱导化疗后无复发生存的独立预测因素。© 2024.肿瘤外科学会。

This study investigated predictive factors for patients with peritoneal metastases of gastric cancer (PMGC) who underwent conversion cytoreductive surgery (C-CRS) and hyperthermic intraperitoneal intraoperative chemotherapy (HIPEC) after responding to induction chemotherapy (laparoscopic HIPEC [LHIPEC]) followed by concomitant systemic and intraperitoneal chemotherapy (bidirectional intraperitoneal and systemic chemotherapy [BIC]).Diagnostic laparoscopy was performed for 62 patients with PMGC between January 2017 and December 2022. The patients underwent LHIPEC and BIC induction chemotherapy using intraperitoneal docetaxel (30 mg/m2) and cisplatin (30 mg/m2), and intravenous chemotherapy for three cycles. The predictive parameters for progression-free and overall survival were analyzed using Kaplan-Meier and Cox regression analyses. The optimal cutoff values for Ki-67 parameters were assessed using receiver operating characteristic curve analysis.The study retrospectively examined 36 (58 %) of 62 patients who responded to induction therapy and underwent C-CRS or HIPEC. A Ki-67 index lower than 10 (p = 0.000), lymph node involvement (LNI) less than 2 (p = 0.039), and an omental lesion size score lower than 0.5 cm (p = 0.002) were predictive of recurrence-free and overall survival in addition to completeness of cytoreduction and the peritoneal cancer index. Cox regression analysis showed that the independent factors associated with recurrence-free survival were decreased Ki-67 expression (≥10 % vs <10 %) (hazard ratio [HR] 4.7; 95 % confidence interval [CI] 1.6-5.210; p = 0.020) and LNI higher than 2 (HR 1.92; 95% CIS 0.923-4.0; p = 0.023).Lymph node involvement and decreased Ki-67 expression are independent predictive factors of recurrence-free survival for patients with PMGC after induction chemotherapy.© 2024. Society of Surgical Oncology.