Zhu Zheng-gang, Tang Rui, Yan Min, Chen Jun, Yang Qiu-meng, Li Shen, Yao Xue-xin, Zhang Jun, Yin Hao-ran, Lin Yan-zhen
Department of General Surgery, Ruijin Hospital, Shcool of Medicine, Shanghai Jiaotong University, Shanghai Institute of Digestive Surgery, Shanghai 200025, China.
Zhonghua Wei Chang Wai Ke Za Zhi. 2006 Jan;9(1):26-30.
To investigate the clinical effect of intraoperative peritoneal hyperthermic chemotherapy (IPHC) for advanced gastric cancer (AGC).
A total of 118 AGC patients with serosal invasion were enrolled in this study from 1998 to 2001. Among these cases, 96 patients without macroscopic peritoneal metastases were selected for prophylactic study, including 42 cases with IPHC and 54 cases without IPHC as control. Other 22 patients with macroscopic peritoneal metastases were selected for therapeutic study, including 10 cases with IPHC and 12 without IPHC. Postoperative survival rate and peritoneal recurrence were compared.
For prophylactic study, the 1, 2 and 4 years survival rates were 85.7%, 81.0% and 63.9% respectively in the patients with IPHC,significantly higher than 77.3%, 61.0% and 50.8% in the patients without IPHC. Cox ratio hazard model revealed that IPHC procedure was an independent prognostic factor. More patients in the control group suffered from peritoneal recurrence than those in IPHC group (34.7% vs 10.3%). For therapeutic study,the median survival period of the patients with IPHC was 10 months, higher than 5 months in the patients without IPHC. The overall 1, 2, 4 year survival rates were 76.9%, 69.2%, 55.2% respectively in all cases with IPHC, higher than 66.2%, 49.7%, 41.4% in the cases without IPHC.
IPHC procedure can improve the prognosis of AGC patients with serosal invasion, reduce the risk for peritoneal recurrence, and is an independent prognostic factor.
探讨术中腹腔热灌注化疗（IPHC）治疗进展期胃癌（AGC）的临床效果。
1998年至2001年共纳入118例伴有浆膜侵犯的AGC患者。其中，选取96例无肉眼可见腹膜转移的患者进行预防性研究，包括42例行IPHC的患者和54例未行IPHC的患者作为对照。另外22例有肉眼可见腹膜转移的患者进行治疗性研究，包括10例行IPHC的患者和12例未行IPHC的患者。比较术后生存率和腹膜复发情况。
预防性研究中，行IPHC的患者1年、2年和4年生存率分别为85.7%、81.0%和63.9%，显著高于未行IPHC的患者（77.3%、61.0%和50.8%）。Cox比例风险模型显示IPHC手术是一个独立的预后因素。对照组发生腹膜复发的患者比IPHC组更多（34.7%对10.3%）。治疗性研究中，行IPHC的患者中位生存期为10个月，高于未行IPHC的患者（5个月）。所有行IPHC的患者总体1年、2年、4年生存率分别为76.9%、69.2%、55.2%，高于未行IPHC的患者（66.2%、49.7%、41.4%）。
IPHC手术可改善伴有浆膜侵犯的AGC患者的预后，降低腹膜复发风险，是一个独立的预后因素。
