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儿童播散性腹腔内恶性肿瘤的细胞减灭术(CRS)和腹腔内热灌注化疗(HIPEC)——单机构经验

Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) for disseminated intra-abdominal malignancies in children-a single-institution experience.

作者信息

Zmora Osnat, Hayes-Jordan Andrea, Nissan Aviram, Kventsel Iris, Newmann Yoram, Itskovsky Kira, Ash Shifra, Levy-Mendelovich Sarina, Shinhar Daniel, Ben-Yaakov Almog, Toren Amos, Bilik Ron

机构信息

Department of Pediatric Surgery, the Edmond and Lily Safra Children's Hospital, Chaim Sheba Medical Center, Tel-Hashomer 52621, Israel. Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.

Departmentof Pediatric Surgery, MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030, USA.

出版信息

J Pediatr Surg. 2018 Jul;53(7):1381-1386. doi: 10.1016/j.jpedsurg.2017.09.014. Epub 2017 Oct 2.

Abstract

PURPOSE

Our purpose was to present our institutional experience with performing complete cytoreduction surgery and heated intraoperative chemotherapy (CRS-HIPEC) for children with disseminated intraabdominal malignancies, guided by a leading international center performing CRS-HIPEC in children.

METHODS

Retrospective chart review of all cases of CRS-HIPEC in children in our institution, examining diagnosis, preoperative management, operative management, postoperative treatment, short term outcome including length of stay and complications, and long term outcome including survival and recurrence of disease.

RESULTS

9 children underwent CRS-HIPEC over 48months. The mean age of the patients was 8years. Tumors were: rhabdomyosarcoma (RMS), mesothelioma, Sertoli-Leydig, desmoplastic small round cell tumor, colon carcinoma and Wilms' tumor. Most patients received intraperitoneal cisplatin. Short term outcome was very good with median length of hospital stay of 13days and low rate of complications. Seven patients were alive at last follow up. Five patients developed a recurrent disease. Recurrence was intraabdominal in two of these patients.

CONCLUSIONS

CRS-HIPEC for children with disseminated intraabdominal malignancies performed in a dedicated institution and with guidance by a leading international center can be performed safely.

TYPE OF STUDY

Treatment study.

LEVEL OF EVIDENCE

IV.

摘要

目的

我们的目的是介绍在一家国际领先的儿童CRS-HIPEC中心的指导下,我们机构对患有播散性腹腔内恶性肿瘤的儿童进行完整细胞减灭术和术中热化疗(CRS-HIPEC)的经验。

方法

对我们机构中所有儿童CRS-HIPEC病例进行回顾性病历审查,检查诊断、术前管理、手术管理、术后治疗、短期结局(包括住院时间和并发症)以及长期结局(包括生存率和疾病复发)。

结果

9名儿童在48个月内接受了CRS-HIPEC。患者的平均年龄为8岁。肿瘤包括:横纹肌肉瘤(RMS)、间皮瘤、支持-间质细胞瘤、促纤维增生性小圆细胞瘤、结肠癌和肾母细胞瘤。大多数患者接受了腹腔内顺铂治疗。短期结局非常好,中位住院时间为13天,并发症发生率低。在最后一次随访时,7名患者存活。5名患者出现疾病复发。其中两名患者复发位于腹腔内。

结论

在专业机构并在国际领先中心的指导下,对患有播散性腹腔内恶性肿瘤的儿童进行CRS-HIPEC可以安全实施。

研究类型

治疗研究。

证据水平

IV级。

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