目前，胰腺导管腺癌（PDAC）的腹膜转移（PM）通常仅采用姑息性全身化疗治疗，效果不佳。细胞减灭手术（CRS）和体外热化疗（HIPEC）可能对高度选择的患者提供肿瘤学效益。回顾性分析符合以下标准的PDAC和孤立性PM患者：在2017年至2022年期间完成≥6个月全身化疗并具有客观反应。所有患者符合我们先前发表的PDAC CRS/HIPEC方案的纳入/排除标准。将接受CRS/HIPEC的患者与接受单独全身疗法的匹配患者进行比较。评估自PM诊断以来的总体生存期（OS）和自CRS/HIPEC以来的无进展生存期（PFS）。 总共有61名患者符合纳入标准：38名接受单独全身治疗，23名接受CRS/HIPEC。基线预后因素没有差异，包括年龄、性别、肿瘤大小、肿瘤位置、解剖可切除性或血清癌胚抗原（CA）19-9水平（p>0.05）。接受单独全身治疗的患者PM诊断后的中位OS为19个月，1、2和3年的OS分别为81%、31%和8%。相比之下，接受CRS/HIPEC的患者PM诊断后的中位OS为41个月，1、2和3年的OS分别为91%、66%和59%（p=0.002）。在达到完全减灭（CC-0）的21名患者中，未施行辅助治疗，中位PFS为17个月。 高度选择的PDAC和PM患者接受CRS/HIPEC可获得有希望的肿瘤学效果，这是单独进行全身化疗无法达到的。需要进一步研究并持续进行（NCT04858009）。©2023。外科肿瘤学协会。

Peritoneal metastases (PM) from pancreatic ductal adenocarcinoma (PDAC) are currently treated with palliative systemic chemotherapy alone, with unsatisfactory results. Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) may provide an oncologic benefit for highly selected patients.Patients with PDAC and isolated PM who completed ≥ 6 months of systemic chemotherapy with objective response between 2017 and 2022 were retrospectively reviewed. All patients met the inclusion/exclusion criteria as per our previously published PDAC CRS/HIPEC protocol. Patients who underwent CRS/HIPEC were compared with matched patients who underwent systemic therapy alone. Overall survival (OS) from diagnosis of PM and progression-free survival (PFS) from CRS/HIPEC was evaluated.In total, 61 patients met the inclusion criteria: 38 underwent systemic therapy alone and 23 CRS/HIPEC. There were no differences in baseline prognostic factors, including age, sex, tumor size, tumor location, anatomic resectability, or serum cancer antigen (CA) 19-9 (p > 0.05). Median OS from PM diagnosis in patients who underwent systemic therapy alone was 19 months with 1, 2, and 3 year OS of 81%, 31%, and 8%, respectively. In contrast, median OS from PM diagnosis in patients who underwent CRS/HIPEC was 41 months with improved 1, 2, and 3 year OS of 91%, 66%, and 59%, respectively (p = 0.002). In the 21 patients who achieved complete cytoreduction (CC-0), no adjuvant therapy was administered and the median PFS was 17 months.CRS/HIPEC in highly selected patients with PDAC and PM results in promising oncologic outcomes that are unlikely to be achieved with systemic chemotherapy alone. Further investigation is warranted and ongoing (NCT04858009).© 2023. Society of Surgical Oncology.