结直肠癌腹膜转移治疗中心的建设

Establishment of treatment center for peritoneal metastasis in colorectal cancer

结直肠癌腹膜转移患者预后较差,目前以肿瘤细胞减灭术(CRS)联合腹腔热灌注化疗(HIPEC)为主的综合治疗体系显著提高了患者的生存。然而CRS和HIPEC的适应证要求严格,操作难度高,并发症发生率和病死率高。经验不足的中心开展CRS+HIPEC可能会降低患者的生存率及生活质量。建立专科诊治中心可以为规范化的临床诊治提供保障。本文首先介绍了建立结直肠癌腹膜转移治疗中心的必要性及国内外腹膜表面恶性肿瘤诊治中心建设的概况。然后重点介绍了笔者团队结直肠癌腹膜转移治疗中心的建设经验,强调了中心建设必须要做好两方面:一方面要实现临床上的优化,加强各个环节的专业化;另一方面要确保患者的治疗质量,维护好每位患者的权利、福祉和健康。

The prognosis of patients with peritoneal metastasis from colorectal cancer is poor.At present,the comprehensive treatment system based on cytoreductive surgery(CRS)combined with hyperthermic intraperitoneal chemotherapy(HIPEC)has significantly improved the survival of these patients.However,CRS and HIPEC have strict indications,high procedural difficulty,and high morbidity and mortality.If CRS+HIPEC is performed in an inexperienced center,overall survival and quality of life of patients may bo compromised.The establishment of specialized diagnosis and treatment centers can provide a guarantee for standardized clinical diagnosis and treatment.In this review,we first introduced the necessity of establishing a colorectal cancer peritoneal metastasis treatment center and the construction situation of the diagnosis and treatment center for peritoneal surface malignancies at home and abroad.Then we focused on introducing our construction experience of the colorectal peritoneal metastasis treatment center,and emphasized that the construction of the center must be done well in two aspects:firstly,the clinical optimization should be realized and the specialization of the whole workflow should be strengthened;secondly,we should ensure the quality of patient care and the rights,well-being and health of every patient.