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腹腔热灌注化疗减瘤术:对一个新设立的腹膜恶性肿瘤治疗项目的疗效与成本评估

Cytoreduction with hyperthermic intraperitoneal chemotherapy: an appraisal of outcomes and cost at a newly established peritoneal malignancy program.

作者信息

Hinkle Nathan M, MacDonald James, Sharpe John P, Dickson Paxton, Deneve Jeremiah, Munene Gitonga

机构信息

Department of Surgery, University of Tennessee Health Science Center, Memphis, TN, USA.

College of Medicine, University of Tennessee Health Science Center, Memphis, TN, USA.

出版信息

Am J Surg. 2016 Sep;212(3):413-8. doi: 10.1016/j.amjsurg.2016.01.022. Epub 2016 Mar 21.

Abstract

BACKGROUND

Outcome measures after cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS/HIPEC) for peritoneal carcinomatosis in established centers are well defined. However, results from newly emerging US centers have not been reported.

METHODS

This is a retrospective review of a prospectively maintained database of patients with peritoneal malignancies undergoing CRS/HIPEC.

RESULTS

Fifty-six patients underwent exploratory laparotomy with 36 receiving CRS/HIPEC over 36 months. The median peritoneal cancer index score was 18, and the cytoreduction 0/1 rate was 92%. Postoperative major morbidity was 16.7% with one perioperative death. The median length of hospital stay and intensive care unit days were 9 and 3 days, respectively. Disease-free survival in high-grade vs low-grade tumors was 12.6 and 31.0 months (P, .03), respectively. Average direct cost for patients undergoing CRS/HIPEC was $25,917.

CONCLUSIONS

Our emerging center's short-term results are comparable with established programs with a trend toward more selective intraoperative judgment on who undergoes CRS/HIPEC.

摘要

背景

在成熟的医疗中心,对于腹膜癌患者进行细胞减灭术联合腹腔热灌注化疗(CRS/HIPEC)后的疗效评估指标已有明确界定。然而,美国新兴医疗中心的相关结果尚未见报道。

方法

这是一项对前瞻性维护的接受CRS/HIPEC的腹膜恶性肿瘤患者数据库的回顾性研究。

结果

56例患者接受了剖腹探查术,其中3年来有36例接受了CRS/HIPEC。腹膜癌指数评分中位数为18,细胞减灭0/1率为92%。术后严重并发症发生率为16.7%,围手术期死亡1例。住院时间中位数和重症监护病房住院天数分别为9天和3天。高级别肿瘤与低级别肿瘤的无病生存期分别为12.6个月和31.0个月(P = 0.03)。接受CRS/HIPEC患者的平均直接费用为25,917美元。

结论

我们新兴医疗中心的短期结果与成熟项目相当,在对哪些患者进行CRS/HIPEC的术中判断上有更具选择性的趋势。

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