Division of Gastroenterology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan.
Eur J Cancer Care (Engl). 2013 Jul;22(4):468-73. doi: 10.1111/ecc.12052. Epub 2013 Jun 3.
Cancer patients with terminal stage peritoneal carcinomatosis are often unable to eat, rendering total parenteral nutrition (TPN) as the only option to avoid starvation. In this retrospective study, we reviewed the medical records of 46 patients with peritoneal carcinomatosis and compared them to the records of 51 patients who had gastrointestinal malignancy without evidence of peritoneal carcinomatosis. The factors evaluated include demographic data, cause of primary malignancy, ascites formation, anthropometric measurements, laboratory tests, and outcome measurements as well as factors associated with greater than 90-day survival. In-hospital mortality was observed in 31 of the 46 patients with peritoneal carcinomatosis, with a median survival time of 40 days (4-148 days) for all 46 patients. The median duration of TPN administration in the peritoneal carcinomatosis group was 24.1 ± 27.4 days (3-68 days). Severe infection related to TPN application was seen in 5/46 (10.7%) patients with peritoneal carcinomatosis and 6/51 (9.8%) patients without peritoneal carcinomatosis. The length of survival varied widely among terminal patients with peritoneal carcinomatosis. The average survival time in peritoneal carcinomatosis patients receiving TPN was short, indicating that the nutrition support of TPN was relatively suboptimal. Ascites was not a prognostic factor for peritoneal carcinomatosis, while body mass index was a predictor for 90-day survival.
患有终末期腹膜癌病的癌症患者通常无法进食，因此全肠外营养（TPN）是避免饥饿的唯一选择。在这项回顾性研究中，我们回顾了 46 例腹膜癌病患者的病历，并将其与 51 例无腹膜癌病证据的胃肠道恶性肿瘤患者的病历进行了比较。评估的因素包括人口统计学数据、主要恶性肿瘤的原因、腹水形成、人体测量学测量、实验室检查和结果测量以及与 90 天以上生存相关的因素。46 例腹膜癌病患者中有 31 例在住院期间死亡，所有 46 例患者的中位生存时间为 40 天（4-148 天）。腹膜癌病组 TPN 给药的中位持续时间为 24.1±27.4 天（3-68 天）。5/46（10.7%）例腹膜癌病患者和 6/51（9.8%）例无腹膜癌病患者出现与 TPN 应用相关的严重感染。患有腹膜癌病的终末期患者的生存时间差异很大。接受 TPN 的腹膜癌病患者的平均生存时间较短，表明 TPN 的营养支持相对不理想。腹水不是腹膜癌病的预后因素，而体重指数是 90 天生存的预测因素。
