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摘要:
腹膜癌是指在腹膜上发生和（或）发展的一类恶性肿瘤，包括原发性腹膜癌和继发性腹膜癌。既往认为腹膜癌是一种终末期疾病，无特殊治疗，患者生存期短，预后差。随着对腹膜癌认识的转变，肿瘤学界将其视为一种可治性区域癌转移，开创了以肿瘤细胞减灭术加腹腔热灌注化疗为核心的综合治疗技术体系，并以此建立了专业化腹膜癌诊疗中心，显著延长了患者生存，部分患者甚至能达到临床治愈。然而在中国，目前规范化腹膜癌诊疗中心少，但腹膜癌患者数量庞大，大部分患者得不到规范化治疗，导致生存和预后并不理想。本文旨在根据我国国家癌症中心发布的癌症新发病例统计数据，结合腹膜癌的临床预后资料，按照临床流行病学的研究方法，估算我国所需腹膜癌诊疗中心数，为推广我国腹膜癌规范化诊疗技术体系提供数据支撑，促进腹膜肿瘤学科发展。
Abstract:Peritoneal metastases (PM) are defined as the primary or secondary occurrence/progression of malignant tumor in peritoneum. PM were previously thought to be a terminal disease without effective treatment, with short survival and poor prognosis. With the change in the understanding of PM, the oncology communities regard it as a curable regional cancer metastasis, and create a comprehensive treatment technology system with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy as the core, and establish professional PM treatment centers based on this. The professional PM treatment centers have significantly prolonged the survival of patients, and some patients can even achieve clinical cure. However, in China, there are very few professional PM treatment centers, but the number of PM patients is huge, and most of the patients can't receive professional treatment, resulting in poor survival and prognosis. Based on the cancer statistics in 2015 published by China National Cancer Center Registry and clinical outcome literature on peritoneal metastasis, this paper uses clinical epidemiology methodology to calculate the number of newly diagnosed patients with peritoneal metastasis, to estimate the number of specialized peritoneal cancer centers required, to provide data support for the promotion of professional treatment technology system for PM in our country, and to boost the development of peritoneal oncology.
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Competing interests: The authors declare that they have no competing interests.作者贡献：杨锐：文献检索、文章撰写苏延冬、马茹：文章修改安松林、林育林：文献检索李雁：文章构思、文章修改
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表 1 我国2015年新发癌症病例数、PM年新发例数及需规范化PM诊疗中心数
Table 1 New cancer cases in 2015, annual number of new PM cases and professional peritoneal treatment centers needed in China
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[1] 李雁. 腹膜癌研究之我见[J]. 中国肿瘤临床, 2012, 39(22): 1685-1686. doi: 10.3969/j.issn.1000-8179.2012.22.001 Li Y. My opinion on peritoneal cancer research[J]. Zhongguo Zhong Liu Lin Chuang, 2012, 39(22): 1685-1686. doi: 10.3969/j.issn.1000-8179.2012.22.001
[2] 李雁, 周云峰, 梁寒, 等. 细胞减灭术加腹腔热灌注化疗治疗腹膜表面肿瘤的专家共识[J]. 中国肿瘤临床, 2015, 42(4): 198-206. doi: 10.3969/j.issn.1000-8179.20150013 Li Y, Zhou YF, Liang H, et al. Expert consensus on cytoreductive surgery plus intraperitoneal hyperthermic chemotherapy in the treatment of peritoneal surface oncology[J]. Zhongguo Zhong Liu Lin Chuang, 2015, 42(4): 198-206. doi: 10.3969/j.issn.1000-8179.20150013
[3] 詹宏杰, 梁寒. 腹腔热灌注化疗在腹膜癌中的应用现状[J]. 肿瘤防治研究, 2021, 48(4): 327-332. doi: 10.3971/j.issn.1000-8578.2021.20.1280 Zhan HJ, Liang H. Current Situation of Hyperthermic Intraperitoneal Chemotherapy in Peritoneal Carcinoma[J]. Zhong Liu Fang Zhi Yan Jiu, 2021, 48(4): 327-332. doi: 10.3971/j.issn.1000-8578.2021.20.1280
[4] Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J]. CA Cancer J Clin, 2021, 71(3): 209-249. doi: 10.3322/caac.21660
[5] Ajani JA, D'Amico TA, Bentrem DJ, et al. Gastric cancer, version 2. 2022, NCCN clinical practice guidelines in oncology[J]. J Natl Compr Canc Netw, 2022, 20(2): 167-192. doi: 10.6004/jnccn.2022.0008
[6] Thomassen I, van Gestel YR, van Ramshorst B, et al. Peritoneal carcinomatosis of gastric origin: A population-based study on incidence, survival and risk factors[J]. Int J Cancer, 2014, 134(3): 622-628. doi: 10.1002/ijc.28373
[7] Kang JH, Lee SI, Lim DH, et al. Salvage chemotherapy for pretreated gastric cancer: A randomized phase iii trial comparing chemotherapy plus best supportive care with best supportive care alone[J]. J Clin Oncol, 2012, 30(13): 1513-1518. doi: 10.1200/JCO.2011.39.4585
[8] Brandl A, Yonemura Y, Glehen O, et al. Long term survival in patients with peritoneal metastasised gastric cancer treated with cytoreductive surgery and HIPEC: A multi-institutional cohort from PSOGI[J]. Eur J Surg Oncol, 2021, 47(1): 172-180. doi: 10.1016/j.ejso.2020.10.006
[9] Yu P, Ye Z, Dai G, et al. Neoadjuvant systemic and hyperthermic intraperitoneal chemotherapy combined with cytoreductive surgery for gastric cancer patients with limited peritoneal metastasis: A prospective cohort study[J]. BMC Cancer, 2020, 20(1): 1108. doi: 10.1186/s12885-020-07601-x
[10] Ji ZH, Yu Y, Liu G, et al. Peritoneal cancer index (PCI) based patient selecting strategy for complete cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy in gastric cancer with peritoneal metastasis: A single-center retrospective analysis of 125 patients[J]. Eur J Surg Oncol, 2021, 47(6): 1411-1419. doi: 10.1016/j.ejso.2020.11.139
[11] Koemans WJ, Lurvink RJ, Grootscholten C, et al. Synchronous peritoneal metastases of gastric cancer origin: Incidence, treatment and survival of a nationwide Dutch cohort[J]. Gastric Cancer, 2021, 24(4): 800-809. doi: 10.1007/s10120-021-01160-1
[12] Maehara Y, Hasuda S, Koga T, et al. Postoperative outcome and sites of recurrence in patients following curative resection of gastric cancer[J]. Br J Surg, 2000, 87(3): 353-357.
[13] Chen W, Zheng R, Baade PD, et al. Cancer statistics in China, 2015[J]. CA Cancer J Clin, 2016, 66(2): 115-132. doi: 10.3322/caac.21338
[14] 朱正纲. 预防与治疗胃癌腹膜转移的若干关键问题[J]. 外科理论与实践, 2021, 26(1): 1-6. doi: 10.16139/j.1007-9610.2021.01.001 Zhu ZG. Several key issues in the prevention and treatment of gastric cancer peritoneal metastasis[J]. Wai Ke Li Lun Yu Shi Jian, 2021, 26(1): 1-6. doi: 10.16139/j.1007-9610.2021.01.001
[15] van Gestel YR, Thomassen I, Lemmens VE, et al. Metachronous peritoneal carcinomatosis after curative treatment of colorectal cancer[J]. Eur J Surg Oncol, 2014, 40(8): 963-969. doi: 10.1016/j.ejso.2013.10.001
[16] Sánchez-Hidalgo JM, Rodríguez-Ortiz L, Arjona-Sánchez Á, et al. Colorectal peritoneal metastases: Optimal management review[J]. World J Gastroenterol, 2019, 25(27): 3484-3502. doi: 10.3748/wjg.v25.i27.3484
[17] Quénet F, Elias D, Roca L, et al. Cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy versus cytoreductive surgery alone for colorectal peritoneal metastases (prodige 7): A multicentre, randomised, open-label, phase 3 trial[J]. Lancet Oncol, 2021, 22(2): 256-266. doi: 10.1016/S1470-2045(20)30599-4
[18] van de Vlasakker VCJ, Lurvink RJ, Cashin PH, et al. The impact of PRODIGE 7 on the current worldwide practice of CRS-HIPEC for colorectal peritoneal metastases: A web-based survey and 2021 statement by peritoneal surface oncology group international (PSOGI)[J]. Eur J Surg Oncol, 2021, 47(11): 2888-2892. doi: 10.1016/j.ejso.2021.05.023
[19] Lemmens VE, Klaver YL, Verwaal VJ, et al. Predictors and survival of synchronous peritoneal carcinomatosis of colorectal origin: A population-based study[J]. Int J Cancer, 2011, 128(11): 2717-2725. doi: 10.1002/ijc.25596
[20] Segelman J, Granath F, Holm T, et al. Incidence, prevalence and risk factors for peritoneal carcinomatosis from colorectal cancer[J]. Br J Surg, 2012, 99(5): 699-705. doi: 10.1002/bjs.8679
[21] Kerscher AG, Chua TC, Gasser M, et al. Impact of peritoneal carcinomatosis in the disease history of colorectal cancer management: A longitudinal experience of 2406 patients over two decades[J]. Br J Cancer, 2013, 108(7): 1432-1439. doi: 10.1038/bjc.2013.82
[22] Quere P, Facy O, Manfredi S, et al. Epidemiology, management, and survival of peritoneal carcinomatosis from colorectal cancer: A population-based study[J]. Dis Colon Rectum, 2015, 58(8): 743-752. doi: 10.1097/DCR.0000000000000412
[23] Ravn S, Heide-Jørgensen U, Christiansen CF, et al. Overall risk and risk factors for metachronous peritoneal metastasis after colorectal cancer surgery: A nationwide cohort study[J]. BJS Open, 2020, 4(2): 284-292. doi: 10.1002/bjs5.50247
[24] Steffen T, Häller L, Bijelic L, et al. Decision-making analysis for hyperthermic intraperitoneal chemotherapy in ovarian cancer: A survey by the executive committee of the peritoneal surface oncology group international (PSOGI)[J]. Oncology, 2021, 99(1): 41-48. doi: 10.1159/000510098
[25] Prat J, FIGO Committee on Gynecologic Oncology. Staging classification for cancer of the ovary, fallopian tube, and peritoneum: Abridged republication of guidelines from the international federation of gynecology and obstetrics (FIGO)[J]. Obstet Gynecol, 2015, 126(1): 171-174. doi: 10.1097/AOG.0000000000000917
[26] du Bois A, Reuss A, Pujade-Lauraine E, et al. Role of surgical outcome as prognostic factor in advanced epithelial ovarian cancer: A combined exploratory analysis of 3 prospectively randomized phase 3 multicenter trials: By the arbeitsgemeinschaft gynaekologische onkologie studiengruppe ovarialkarzinom (AGO-OVAR) and the groupe d'investigateurs nationaux pour les etudes des cancers de l'ovaire (GINECO)[J]. Cancer, 2009, 115(6): 1234-1244. doi: 10.1002/cncr.24149
[27] Lheureux S, Gourley C, Vergote I, et al. Epithelial ovarian cancer[J]. Lancet, 2019, 393(10177): 1240-1253. doi: 10.1016/S0140-6736(18)32552-2
[28] 李雁, 许洪斌, 彭正, 等. 肿瘤细胞减灭术加腹腔热灌注化疗治疗腹膜假黏液瘤专家共识[J]. 中华医学杂志, 2019, 99(20): 1527-1535. doi: 10.3760/cma.j.issn.0376-2491.2019.20.003 Li Y, Xu HB, Peng Z, et al. Expert consensus on cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy for the treatment of pseudomyxoma peritonei[J]. Zhonghua Yi Xue Za Zhi, 2019, 99(20): 1527-1535. doi: 10.3760/cma.j.issn.0376-2491.2019.20.003
[29] Smeenk RM, van Velthuysen ML, Verwaal VJ, et al. Appendiceal neoplasms and pseudomyxoma peritonei: A population based study[J]. Eur J Surg Oncol, 2008, 34(2): 196-201. doi: 10.1016/j.ejso.2007.04.002
[30] Patrick-Brown T, Carr NJ, Swanson DM, et al. Estimating the prevalence of pseudomyxoma peritonei in Europe using a novel statistical method[J]. Ann Surg Oncol, 2021, 28(1): 252-257. doi: 10.1245/s10434-020-08655-8
[31] Moran B, Baratti D, Yan TD, et al. Consensus statement on the loco-regional treatment of appendiceal mucinous neoplasms with peritoneal dissemination (pseudomyxoma peritonei)[J]. J Surg Oncol, 2008, 98(4): 277-282. doi: 10.1002/jso.21054
[32] Chua TC, Moran BJ, Sugarbaker PH, et al. Early- and long-term outcome data of patients with pseudomyxoma peritonei from appendiceal origin treated by a strategy of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy[J]. J Clin Oncol, 2012, 30(20): 2449-2456. doi: 10.1200/JCO.2011.39.7166
[33] Cai SX, Zhang CH, Zhang X, et al. Epidemiology of occupational asbestos-related diseases in China[J]. Ind Health, 2001, 39(2): 75-83. doi: 10.2486/indhealth.39.75
[34] 唐慧娟, 陈天辉, 蒋曦依, 等. 石棉所致恶性间皮瘤的流行现状及其早期诊断[J]. 国际流行病学传染病学杂志, 2017, 44(4): 278-281. doi: 10.3760/cma.j.issn.1673-4149.2017.04.014 Tang HJ, Chen TH, Jiang XY, et al. Advances on epidemic status of asbestos-related malignant mesothelioma and its early diagnosis[J]. Guo Ji Liu Xing Bing Xue Chuan Ran Bing Xue Za Zhi, 2017, 44(4): 278-281. doi: 10.3760/cma.j.issn.1673-4149.2017.04.014
[35] 黄晓云, 叶俏. 石棉所致肿瘤的流行病学研究进展[J]. 中华劳动卫生职业病杂志, 2021, 39(3): 233-236. doi: 10.3760/cma.j.cn121094-20200226-00089 Huang XY, Ye Q. Asbestos exposure and asbestos related malignant diseases: an epidemiological review[J]. Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi, 2021, 39(3): 233-236. doi: 10.3760/cma.j.cn121094-20200226-00089
[36] Zhao J, Zuo T, Zheng R, et al. Epidemiology and trend analysis on malignant mesothelioma in China[J]. Chin J Cancer Res, 2017, 29(4): 361-368. doi: 10.21147/j.issn.1000-9604.2017.04.09
[37] Yan TD, Deraco M, Baratti D, et al. Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for malignant peritoneal mesothelioma: Multi-institutional experience[J]. J Clin Oncol, 2009, 27(36): 6237-6242. doi: 10.1200/JCO.2009.23.9640
[38] Lim MC, Chang SJ, Park B, et al. Survival after hyperthermic intraperitoneal chemotherapy and primary or interval cytoreductive surgery in ovarian cancer: A randomized clinical trial[J]. JAMA Surg, 2022, 157(5): 374-383. doi: 10.1001/jamasurg.2022.0143
[39] Bonnot PE, Lintis A, Mercier F, et al. Prognosis of poorly cohesive gastric cancer after complete cytoreductive surgery with or without hyperthermic intraperitoneal chemotherapy (CYTO-CHIP study)[J]. Br J Surg, 2021, 108(10): 1225-1235. doi: 10.1093/bjs/znab200
[40] Yan TD, Deraco M, Baratti D, et al. Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for malignant peritoneal mesothelioma: multi-institutional experience[J]. J Clin Oncol. 2009, 27(36): 6237-6242. doi: 10.1200/JCO.2009.23.9640
[41] Kusamura S, Barretta F, Yonemura Y, et al. The role of hyperthermic intraperitoneal chemotherapy in pseudomyxoma peritonei after cytoreductive surgery[J]. JAMA Surg, 2021, 156(3): e206363. doi: 10.1001/jamasurg.2020.6363
[42] 国家卫生健康委员会. 中国卫生健康统计年鉴(2021)[M]. 北京: 中国协和医科大学出版社, 2021: 13-14. National Health Commission of the People's Republic of China. China Health Statistical Yearbook[M]. Beijing: China Union Medical College Press, 2021: 13-14.
[43] 于洋, 李鑫宝, 林育林, 等. 肿瘤细胞减灭术联合腹腔热灌注化疗治疗腹膜癌1 384例疗效分析[J]. 中华胃肠外科杂志, 2021, 24(3): 230-239. https://www.cnki.com.cn/Article/CJFDTOTAL-GAYX201622042.htm Yu Y, Li XB, Lin YL, et al. Efficacy of 1, 384 cases of peritoneal carcinomatosis underwent cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy[J]. Zhonghua Wei Chang Wai Ke Za Zhi, 2021, 24(3): 230-239. https://www.cnki.com.cn/Article/CJFDTOTAL-GAYX201622042.htm
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