Huang Yeqian, Alzahrani Nayef A, Chua Terence C, Liauw Winston, Morris David L
Department of Surgery, University of New South Wales, St George Hospital, New South Wales, Australia.
Department of Surgery, University of New South Wales, St George Hospital, New South Wales, Australia; College of Medicine, Imam Muhammad ibn Saud Islamic University, Riyadh, Saudi Arabia.
Am J Surg. 2017 Jun;213(6):1024-1030. doi: 10.1016/j.amjsurg.2016.09.046. Epub 2016 Oct 8.
A significant proportion of patients with peritoneal surface malignancy (PSM) experienced recurrence after initial cytoreductive surgery (CRS). Thus the aims of this study were to determine short-term outcomes and long-term survivals associated with repeat CRS.
This was a retrospective study of prospectively collected data of consecutive patients with PSM who underwent CRS by one surgical team at St George Hospital in Sydney, Australia between Jan 1996 and May 2016.
There was no significant difference in hospital mortality (p=0.343) and major morbidity rate (p=0.454). Patients who underwent repeat surgery had a significantly higher 5-year overall survival (OS) rate (p<0.001) and a longer median disease free interval (DFS) (p<0.001). Repeat CRS was also found to be a significant prognostic factor for OS (p<0.001) and DFS (p<0.001).
Repeat CRS with or without perioperative intraperitoneal chemotherapy could provide long-term survival benefits to patients with PSM with acceptable mortality and morbidity rates.
相当一部分腹膜表面恶性肿瘤(PSM)患者在初次肿瘤细胞减灭术(CRS)后出现复发。因此,本研究的目的是确定与重复CRS相关的短期结局和长期生存率。
这是一项对前瞻性收集的数据进行的回顾性研究,研究对象为1996年1月至2016年5月期间在澳大利亚悉尼圣乔治医院由一个手术团队为连续的PSM患者实施CRS的情况。
医院死亡率(p = 0.343)和主要发病率(p = 0.454)无显著差异。接受重复手术的患者5年总生存率(OS)显著更高(p < 0.001),无病间隔中位数(DFS)更长(p < 0.001)。还发现重复CRS是OS(p < 0.001)和DFS(p < 0.001)的重要预后因素。
无论是否进行围手术期腹腔内化疗,重复CRS都可为PSM患者带来长期生存益处,且死亡率和发病率可接受。