Abstract: Advances in indication of cytoreductive surgery of peritoneal metastasis in gastrointestinal cancer        YUAN Zi-xu*,LIN Qing-feng, CAI Jian,et al.*Department of Colorectal Surgery, the Sixth Affiliated Hospital of Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, Guangdong Institute of Gastroenterology, Guangzhou 510655, China
Corresponding author: WANG Hui,E-mail:wangh89@mail.sysu.edu.cn
Abstract    Peritoneal metastasis (PM) is considered to be the terminal stage of gastrointestinal malignancies with poor prognosis and survival. Recently, cytoreductive surgery (CRS) and HIPEC have become the standard recommendations for PM.Peritoneal cancer index (PCI) is the main factor to select CRS. In different types of cancer, the indications of CRS are different. The indication of CRS for colorectal cancer is PCI<20, but PCI scores are not the indicators for CRS in pseudomyxoma peritonei(PMP), appendix tumors and ovary tumors. Preoperative chemotherapy and immunotherapy have extended the indication of CRS in gastrointestinal tumors with PM.

Key words: peritoneal metastasis, cytoreductive surgery, hyperthermic intraperitoneal chemotherapy, indication, colorectal cancer, gastric cancer

摘要： 腹膜转移癌是消化道恶性肿瘤的终末期阶段，预后较差生存期短。近年来肿瘤细胞减灭术（CRS）联合腹腔热灌注化疗（HIPEC）成为腹膜转移治疗的国际标准推荐术式。腹膜癌指数（PCI）评分是目前评估能否行CRS的关键指标。在不同恶性肿瘤中，CRS适应证有所差异。PCI<20分是结直肠癌CRS的主要适应证，但是在腹膜假性黏液瘤（PMP）、阑尾来源肿瘤、卵巢癌中CRS适应证不受PCI评分的限制，术前转化和免疫治疗拓宽了消化道肿瘤腹膜转移的CRS适应证。

关键词: 腹膜转移, 肿瘤细胞减灭术, 腹腔热灌注化疗, 适应证, 结直肠癌, 胃癌