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老年患者的细胞减灭术加腹腔内热化疗。

Cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy in elderly patients.

机构信息

University of Messina, Department of Human Pathology, General Surgery Unit, Via Consolare Valeria, 98125 Messina, Italy.

出版信息

In Vivo. 2011 Jul-Aug;25(4):687-90.

Abstract

BACKGROUND

The treatment of peritoneal malignancies in elderly patients with cytoreductive surgery (CRS) plus hyperthermic intraperitoneal chemotherapy (HIPEC) is an ongoing question due to the high associated surgical risk.

PATIENTS AND METHODS

Thirty patients, 11 (36.7%) older than 65 years, were submitted to CRS plus HIPEC. Criteria of patient eligibility were: peritoneal carcinomatosis of different origin, T3-4 gastric cancer, ECOG performance status ≤2, no extra-abdominal extension and no evidence of bowel obstruction. The median follow-up was 21.5 months (range: 1-63). The purpose of this retrospective study, was to evaluate the feasibility of this approach in elderly patients, with special reference to postoperative morbidity, mortality and survival.

RESULTS

We have recorded, in elderly patients, higher grade 3 and 4 morbidity and mortality, similar mean duration of cytoreductive surgery, of postoperative hospital stay, of median survival and of overall survival rates.

CONCLUSION

Since there no statistical differences, in terms of morbidity and mortality, CRS with HIPEC may also be suitable for elderly patients.

摘要

背景

由于相关手术风险较高,对于接受细胞减灭术(CRS)加腹腔热灌注化疗(HIPEC)的老年患者的腹膜恶性肿瘤的治疗仍然存在争议。

患者和方法

30 名患者,11 名(36.7%)年龄大于 65 岁,接受了 CRS 加 HIPEC。患者选择标准为:不同来源的腹膜癌转移、T3-4 期胃癌、ECOG 体能状态评分≤2、无腹腔外扩散且无肠梗阻证据。中位随访时间为 21.5 个月(范围:1-63)。本回顾性研究的目的是评估该方法在老年患者中的可行性,特别是术后发病率、死亡率和生存率。

结果

我们发现老年患者的 3 级和 4 级发病率和死亡率更高,但细胞减灭术的平均时间、术后住院时间、中位生存时间和总生存率相似。

结论

由于在发病率和死亡率方面没有统计学差异,CRS 加 HIPEC 也可能适用于老年患者。

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