腹膜切开术和疾病腹膜病变的形态外观与接受细胞支出手术的腹膜恶性肿瘤的患者的病理评估相关性

Correlation of Morphological Appearance of Peritoneal Lesions at Laparotomy and Disease at Pathological Assessment in Patients Undergoing Cytoreductive Surgery for Peritoneal Malignancy: Results of Phase I of the PRECINCT Study in 707 Patients

ANNALS OF SURGICAL ONCOLOGY

影响因子:3.50000

分区:医学2区 / 外科2区肿瘤学3区

发表日期:2024 Dec

作者: Aditi Bhatt, Laurent Villeneuve, Armando Sardi, Amine Souadka, Alison Buseck, Brendan J Moran, Basma El Khannousi, Carlos Gonzalez de Pedro, Dario Baratti, Danielle Biacchi, David Morris, Daniel Labow, Edward A Levine, Faheez Mohamed, Gbadebo Adeleke, Gaurav Goswami, Isabelle Bonnefoy, Katherine Cummins Perry, Konstantinos I Votanopoulos, Loma Parikh, Marcello Deraco, Mohammad Alyami, Noah Cohen, Nazim Benzerdjeb, Nehal Shah, Nezha El Bahaoui, Nazanin Khajoueinejad, Pascal Rousset, Perry Shen, Shoma Barat, Sophia Stanford, Selma Khouchoua, Samantha Troob, Sakina Shaikh, Umut Sarpel, Vadim Gushchin, Vasanth Mark Samuel, Vahan Kepenekian, Paolo Sammartino, Olivier Glehen

摘要

区域（腹膜传播的模式和对全身化学疗法的常见和罕见的腹膜肿瘤的反应）是一项前瞻性，多中心的观察性研究。该区域第一阶段的这份报告概述了经验丰富的腹膜恶性中心的手术腹膜癌指数（SPCI）的变化，以及在形态上不同的腹膜病变（PL）中病理证实的疾病的发病率。SPCI以PL的形式出现（包括PL的道理外观）记录为预定格式。提供了六个预先指定的形态学术语。比较了手术和病理发现。形态学细节通常在两个中心记录，结构具有最大的结节，每个区域的肿瘤沉积物的确切尺寸为四个中心。使用的最常见的形态学术语是3091（45.3％）的正常腹膜，2607年的肿瘤结节（38.2％）和786（11.5％）区域的融合疾病。在病变结节的病变评分为2/3的“肿瘤结节”中，病理确认的疾病的发生率明显更高，而病变评分为1（63.1％比31.5％； P <0.001）。在接受新辅助化疗的患者中，病理确认的疾病的发生率与接受前期手术的患者没有显着差异[751（47.7％）和532（51.4％）。 p = 0.069]。在不同中心记录了SPCI的异质性。在“肿瘤结节”中，病理确认的疾病的发生率为49.2％。冷冻部分可以更自由地用于这些病变以帮助临床决策。一项大规模研究涉及不同形态学外观的绘画描述以及与病理发现的相关性。

Abstract

The PRECINCT (Pattern of peritoneal dissemination and REsponse to systemic Chemotherapy IN Common and uncommon peritoneal Tumors) is a prospective, multicenter, observational study. This report from phase I of PRECINCT outlines variations in recording the surgical peritoneal cancer index (sPCI) at experienced peritoneal malignancy centers and the incidence of pathologically confirmed disease in morphologically different peritoneal lesions (PL).The sPCI was recorded in a prespecified format that included the morphological appearance of PL. Six prespecified morphological terms were provided. The surgical and pathological findings were compared.From September 2020 to December 2021, 707 patients were enrolled at 10 centers. The morphological details are routinely recorded at two centers, structure bearing the largest nodule, and exact size of the largest tumor deposit in each region at four centers each. The most common morphological terms used were normal peritoneum in 3091 (45.3%), tumor nodules in 2607 (38.2%) and confluent disease in 786 (11.5%) regions. The incidence of pathologically confirmed disease was significantly higher in 'tumor nodules' with a lesion score of 2/3 compared with a lesion score of 1 (63.1% vs. 31.5%; p < 0.001). In patients receiving neoadjuvant chemotherapy, the incidence of pathologically confirmed disease did not differ significantly from those undergoing upfront surgery [751 (47.7%) and 532 (51.4%) respectively; p = 0.069].The sPCI was recorded with heterogeneity at different centers. The incidence of pathologically confirmed disease was 49.2% in 'tumor nodules'. Frozen section could be used more liberally for these lesions to aid clinical decisions. A large-scale study involving pictorial depiction of different morphological appearances and correlation with pathological findings is indicated.