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高热腹腔内化疗(HIPEC)联合细胞减灭术(CRS)治疗晚期卵巢癌的预后影响:荟萃分析。

The prognosis impact of hyperthermic intraperitoneal chemotherapy (HIPEC) plus cytoreductive surgery (CRS) in advanced ovarian cancer: the meta-analysis.

机构信息

Department of Obstetrics and Gynecology, Beijing Chaoyang Hospital, Capital Medical University, No.8, industrial south road, Chaoyang District, Beijing, China.

Department of Oncology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong Province, China.

出版信息

J Ovarian Res. 2019 Apr 17;12(1):33. doi: 10.1186/s13048-019-0509-1.

DOI:10.1186/s13048-019-0509-1
PMID:30995948
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6472063/
Abstract

BACKGROUND AND OBJECTIVE

Previous studies about the prognostic value of the HIPEC have yielded controversial results. Therefore, this study aims to assess the impact of HIPEC on patients with ovarian cancer.

RESULTS

We included 13 comparative studies, and found that the overall survival (OS) and progression-free survival (PFS) in HIPEC groups were superior to groups without HIPEC treatment in the all total population (HR = 0.54,95% CI:0.45 to 0.66, HR = 0.45, 95% CI: 0.32 to 0.62). Additionally, the subgroup analysis showed that patients with advanced primary ovarian cancers also gained improved OS and PFS benefit from HIPEC (HR = 0.59,95% CI:0.46 to 0.75, HR = 0.41,95% CI:0.32 to 0.54). With regard to recurrent ovarian cancer, HIPEC was associated with improved OS (HR = 0.45,95% CI:0.24 to 0.83), but for the PFS, no correlation was observed between HIPC group and the non-HIPEC group (HR = 0.55,95% CI:0.27 to 1.11). HIPEC also led to favorable clinical outcome (HR = 0.64,95% CI:0.50 to 0.82, HR = 0.36,95% CI:0.20 to 0.65) for stage III or IV ovarian cancer with initial diagnosis.

CONCLUSION

The review indicated that HIPEC-based regimens was correlated with better clinical prognosis for patients with primary ovarian cancers. For recurrent ovarian cancers, HIPEC only improved the OS but did not elicit significant value on the PFS.

摘要

背景与目的

之前关于 HIPEC 预后价值的研究结果存在争议。因此,本研究旨在评估 HIPEC 对卵巢癌患者的影响。

结果

我们纳入了 13 项对照研究,发现总体生存率(OS)和无进展生存率(PFS)在接受 HIPEC 治疗的组中优于未接受 HIPEC 治疗的组(HR=0.54,95%CI:0.45 至 0.66,HR=0.45,95%CI:0.32 至 0.62)。此外,亚组分析表明,晚期原发性卵巢癌患者也从 HIPEC 中获得了改善的 OS 和 PFS 获益(HR=0.59,95%CI:0.46 至 0.75,HR=0.41,95%CI:0.32 至 0.54)。对于复发性卵巢癌,HIPEC 与改善的 OS 相关(HR=0.45,95%CI:0.24 至 0.83),但对于 PFS,HIPC 组与非 HIPEC 组之间无相关性(HR=0.55,95%CI:0.27 至 1.11)。HIPEC 也为初诊为 III 期或 IV 期卵巢癌的患者带来了有利的临床结局(HR=0.64,95%CI:0.50 至 0.82,HR=0.36,95%CI:0.20 至 0.65)。

结论

本综述表明,基于 HIPEC 的方案与原发性卵巢癌患者的更好临床预后相关。对于复发性卵巢癌,HIPEC 仅改善 OS,但对 PFS 没有产生显著价值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4224/6472063/0683c4ea4649/13048_2019_509_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4224/6472063/919b917c0c58/13048_2019_509_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4224/6472063/c4d82af714b0/13048_2019_509_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4224/6472063/0683c4ea4649/13048_2019_509_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4224/6472063/919b917c0c58/13048_2019_509_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4224/6472063/c4d82af714b0/13048_2019_509_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4224/6472063/0683c4ea4649/13048_2019_509_Fig3_HTML.jpg

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