关于围手术期全身化疗 (SC) 对接受 (CRS) 和腹腔热腹腔化疗 (HIPEC) 的弥漫性恶性腹膜间皮瘤 (DMPM) 患者的作用的现有数据是异质且不标准化的。本研究旨在评估 SC 对接受 CRS-HIPEC 的 DMPM 患者生存结果的影响，并确定影响 SC 治疗决定的预后因素。在米兰国家癌症研究所接受 CRS-HIPEC 的患者（1995-2020 年）使用已知协变量的倾向评分匹配进行回顾性分析。患者被分为三组：A 组（新辅助化疗 [NACT] 和无 SC）、B 组（无 SC 和辅助化疗 [ACT]）和 C 组（NACT 和 ACT）。采用Kaplan-Meir法计算总生存期（OS）和无进展生存期（PFS），并采用Cox回归法计算预后因素。中位随访期45个月后（95%置信区间[ A 组为 6.348-83.652 个月，CI]，B 组为 115 个月（95% CI，44.379-185.621 个月），C 组为 88 个月（95% CI，3.296-172.704 个月），该研究分析了 154 名 DMPM患者由匹配组 A (NACT: 60 no-SC: 52 = 112)、B 组 (ACT: 38 no-SC: 38 = 76) 和 C 组 (NACT: 31 ACT: 31 = 62) 组成。接受 ACT 的患者比接受 NACT 的患者具有更好的 5 年 OS 和 PFS。在多变量分析中，ACT 与 OS 提高 48% 显着相关（风险比 [HR]，0.52；95% CI，0.280-0.965，p = 0.038）。对于 PFS，ACT 的相关性未达到统计学显着性（HR，0.531；95% CI，0.266-1.058；p = 0.072）。DMPM 的最佳治疗顺序是 CRS-HIPEC，然后对高危患者进行辅助化疗。对于适合完成 CRS 的患者，前期手术似乎比 NACT 更可取。© 2023。外科肿瘤学会。

The available data on the role of perioperative systemic chemotherapy (SC) for diffuse malignant peritoneal mesothelioma (DMPM) patients undergoing (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) is heterogeneous and unstandardized. This study aimed to evaluate the impact of SC on the survival outcomes of DMPM patients undergoing CRS-HIPEC and to identify prognostic factors that affect the decision to administer SC.Patients who underwent CRS-HIPEC in the National Cancer Institute Milan (1995-2020) were retrospectively analyzed using propensity score-matching of known covariates. The patients were grouped into three groups: group A (neoadjuvant chemotherapy [NACT] and no-SC), group B (no-SC and adjuvant chemotherapy [ACT]), and group C (NACT and ACT). Overall survival (OS) and progression-free survival (PFS) were calculated using the Kaplan-Meir method, and prognostic factors were calculated using the Cox-regression method.After a median follow-up period of 45 months (95% confidence interval [CI], 6.348-83.652 months) for group A, 115 months (95% CI, 44.379-185.621 months) for group B, and 88 months (95% CI, 3.296-172.704 months) for group C, the study analyzed 154 DMPM patients consisting of matched group A (NACT: 60 + no-SC: 52 = 112), group B (ACT: 38 + no-SC: 38 = 76), and group C (NACT: 31 + ACT: 31 = 62). The patients undergoing ACT had better 5-year OS and PFS than the patients undergoing NACT. In the multivariate analysis, ACT was significantly associated with improved OS by 48% (hazard ratio [HR], 0.52; 95% CI, 0.280-0.965, p = 0.038). For PFS, the association of ACT did not reach statistical significance (HR, 0.531; 95% CI, 0.266-1.058; p = 0.072).The optimum treatment sequence for DMPM is CRS-HIPEC followed by adjuvant chemotherapy for high-risk patients. Upfront surgery appears preferable to NACT for patients amenable to complete CRS.© 2023. Society of Surgical Oncology.