结直肠癌经常转移至肝脏和腹膜，预后不良。在选定的患者中，提供细胞减灭术和腹腔热灌注化疗（CRS-HIPEC）的腹膜转移瘤（PM-CRC）以及手术切除治疗的结直肠肝转移瘤（CLM）均显示出总生存期（OS）的益处。然而，CLM 的存在被认为是 CRS-HIPEC 的相对禁忌症，导致该患者组的结果数据缺乏。 2007 年至 2023 年间，PM-CRC 患者在单一国家中心接受了 CRS-HIPEC，并针对以下情况进行了额外干预： CLM 也被包括在内（允许先前对腹膜外和肝外转移进行的治疗）。定义了三组：CLM 之前 CRS-HIPEC（preCRS-HIPEC）； CLM 与 CRS-HIPEC (simCRS-HIPEC) 同时切除； CRS-HIPEC 后 (CRS-HIPEC 后) 后的 CLM，旨在回顾性分析结果。纳入 57 例患者，分为：CRS-HIPEC 前 (n=11)、CRS-HIPEC 前 (n=29) 和 CRS-HIPEC 后 (n=29)。 n=17）。中位腹膜癌指数（PCI）为8，13名患者出现严重并发症（Clavien-Dindo≥3），无90天死亡率。 CRS-HIPEC 后中位 OS 为 48 个月。 PCI 是 OS 的预测因子（HR 1.11，P<0.001）。我们观察到干预组之间的短期或长期结果没有差异。这项研究表明，接受 CRS-HIPEC 的 CLM 患者的 OS 与仅接受 CRS-HIPEC 的报告相当，这可能是由于 PCI 率低所致。同时 CLM 切除不会增加严重并发症的风险。在这个全国队列中，CRS-HIPEC 和 CLM 干预提供了长期生存，表明这种治疗可以提供给选定的 PM-CRC 和 CLM 患者。版权所有 © 2024作者。由 Wolters Kluwer Health, Inc. 出版

Colorectal cancer frequently metastasize to the liver and peritoneum, and is associated with a poor prognosis. In selected patients, a benefit in overall survival (OS) was shown for both peritoneal metastases (PM-CRC) offered cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS-HIPEC), and colorectal liver metastases (CLM) treated with surgical resection. However, the presence of CLM was considered a relative contraindication to CRS-HIPEC, causing a paucity in outcome data in this patient group.Patient with PM-CRC having CRS-HIPEC at a single national center between 2007 and 2023, with additional intervention for CLM, were included (previous curative treatment for extra-peritoneal and extra-hepatic metastases was allowed). Three groups were defined: CLM before CRS-HIPEC (preCRS-HIPEC); CLM resected simultaneously with CRS-HIPEC (simCRS-HIPEC); CLM after CRS-HIPEC (postCRS-HIPEC), aiming to retrospectively analyze outcomes.Fifty-seven patients were included and classified as: preCRS-HIPEC (n=11), simCRS-HIPEC (n=29), and postCRS-HIPEC (n=17). Median peritoneal cancer index (PCI) was 8, 13 patients had severe complications (Clavien-Dindo ≥3), and no 90-day mortality. Median OS was 48 months after CRS-HIPEC. PCI was a predictor of OS (HR 1.11, P<0.001). We observed no difference in short or long-term outcomes between intervention groups.This study demonstrate that patients with CLM having CRS-HIPEC had comparable OS to reports on CRS-HIPEC only, likely explained by a low PCI. Simultaneous CLM resection did not increase the risk of severe complications.In this national cohort, CRS-HIPEC and CLM intervention offers long-term survival, suggesting that this treatment may be offered to selected patients with PM-CRC and CLM.Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.