李鑫宝, 林育林, 姬忠贺, 李雁. 肿瘤细胞减灭术加腹腔热灌注化疗治疗腹膜假黏液瘤182例分析[J]. 中国肿瘤临床, 2018, 45(18): 943-949. DOI: 10.3969/j.issn.1000-8179.2018.18.607
引用本文: 李鑫宝, 林育林, 姬忠贺, 李雁. 肿瘤细胞减灭术加腹腔热灌注化疗治疗腹膜假黏液瘤182例分析[J]. 中国肿瘤临床, 2018, 45(18): 943-949. DOI: 10.3969/j.issn.1000-8179.2018.18.607
shu
Li Xinbao, Lin Yulin, Ji Zhonghe, Li Yan. Cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy in patients with pseudomyxoma peritonei: Analysis of 182 patients at a single center[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2018, 45(18): 943-949. DOI: 10.3969/j.issn.1000-8179.2018.18.607
Citation: Li Xinbao, Lin Yulin, Ji Zhonghe, Li Yan. Cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy in patients with pseudomyxoma peritonei: Analysis of 182 patients at a single center[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2018, 45(18): 943-949. DOI: 10.3969/j.issn.1000-8179.2018.18.607
shu

肿瘤细胞减灭术加腹腔热灌注化疗治疗腹膜假黏液瘤182例分析

Cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy in patients with pseudomyxoma peritonei: Analysis of 182 patients at a single center

    摘要
  • 摘要:
      目的  腹膜假黏液瘤（pseudomyxoma peritonei，PMP）是一种主要来源于阑尾黏液性肿瘤的恶性肿瘤综合征，肿瘤细胞减灭术（cytoreductive surgery，CRS）加腹腔热灌注化疗（hyperthermic intraperitoneal chemotherapy，HIPEC）是国际推荐的PMP标准治疗。本研究旨在评估CRS+HIPEC治疗PMP的疗效及围手术期安全性。
      方法  研究首都医科大学附属北京世纪坛医院2001年1月至2008年5月采用CRS+HIPEC治疗182例PMP临床数据库，进行生存分析，通过单因素和多因素分析筛选独立预后因素，并分析围手术期安全性。
      结果  182例PMP患者接受CRS+HIPEC治疗，低级别PMP 73例（40.1%），部分低级别、部分高级别PMP 50例（27.5%），高级别PMP 53例（29.1%），PMP伴印戒细胞6例（3.3%）；中位腹膜癌指数（peritoneal cancer index，PCI）30分，PCI≥20分为134例（74.0%）；肿瘤细胞减灭程度（completeness of cytoreduction，CC）评分0~1分者为79例（44.1%）；死亡48例（26.4%），生存134例（73.6%），中位生存时间64.7个月（95%CI：43.1~84.3个月）。Cox多因素回归分析发现4个独立预后因素：年龄（HR=12.079，95%CI：1.605~90.916）、CC（HR=0.211，95%CI：0.069~0.641）、是否有吻合口（0个vs. >1个）（HR=5.519，95%CI：1.176~25.907）、吻合口数量（1个vs. >1个）（HR=7.543，95%CI：1.592~35.732）。围手术期死亡率、严重不良事件率分别为1.6%、19.8%。
      结论  PMP患者在腹膜肿瘤专科单位接受CRS+HIPEC治疗，达到完全肿瘤细胞减灭，可延长生存，围手术期安全性可接受。

     

    Abstract:
      Objective  Pseudomyxoma peritonei (PMP) is a clinically malignant tumor syndrome derived from mucin-producing appendiceal tumors, and cytoreductive surgery (CRS) plus hyperthermic intraperitoneal chemotherapy (HIPEC) is a standard treatment for PMP recommended by the Peritoneal Surface Malignancy Group International (PSOGI). This retrospective study analyzed the efficacy and safety of CRS+HIPEC for PMP at our center.
      Methods  This was a retrospective study on the PMP database established at our center. The clinicopathological features, treatment details, and follow-up information on PMP patients were systematically established in this database. Survival analysis was conducted to evaluate the efficacy of treatment; univariate and multivariate analyses were performed to identify the independent prognostic factors. Perioperative adverse events were assessed to evaluate the safety of CRS + HIPEC.
      Results  Among the 182 PMP patients that received CRS+HIPEC, 73 (40.1%) had low-grade PMP, 50 (27.5%) had low-and-high mixed-grade PMP, 53 (29.1%) had high-grade PMP, and 6 (3.3%) had PMP with signet ring cells. The median peritoneal cancer index (PCI) was 30, and 74.0% of the patients had a PCI ≥20. There were 79 patients (44.1%) who had a completeness of cytoreduction (CC) score of 0-1. Of 182 patients, 48 (26.4%) died and 134 (73.6%) were alive, with the median overall survival (OS) from surgery being 64.7 months (95% CI: 43.1-84.3 months). Multivariate analysis and Cox proportional regression model analysis identified 4 independent prognostic factors: age (HR=12.079, 95% CI: 1.605-90.916), CC score (HR=0.211, 95% CI: 0.069-0.641), presence of anastomosis (0 vs. >1) (HR=5.519, 95% CI: 1.176-25.907), and number of anastomoses (1 vs. >1) (HR=7.543, 95% CI: 1.592-35.732). The perioperative mortality rate and serious adverse events rate was 1.6% and 19.8%, respectively.
      Conclusions  PMP patients treated with CRS+HIPEC to achieve complete cytoreduction at experienced centers may experience survival benefits with acceptable safety.

     

    • HTML全文
    • 参考文献(17)
    • 相关文章
    • 施引文献
  • 资源附件(0)

/

返回文章
返回