Zhang Hong-Wei, Yang Jian-Jun, Zheng Ji-Yang, Sun Li, Yang Xue-Wen, Li Guo-Cai
Division of Digestive Surgery, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an 710032.
Division of Digestive Surgery, Xi'an International Medical Centre, Xi'an 710000, Shaanxi Province, China.
Medicine (Baltimore). 2019 Jul;98(30):e16598. doi: 10.1097/MD.0000000000016598.
To evaluate the value of intraperitoneal hyperthermic perfusion (IPHP) in the treatment of gastric cancer.Gastric cancer (GC) is a malignancy with poor prognosis, recent years have demonstrated advances in the use of IPHP for the treatment of advanced gastric cancer (AGC), but the outcome is controversial.Between January 2015 and January 2017, 134 patients with GC were treated with IPHP in our surgery department, 130 of them were advanced GC patients, and other 1439 cases were treated without IPHP for comparison. In this retrospective cohort study, demographic, perioperative data, and follow-up data were analyzed by univariant analysis, Kaplan-Meier and Cox regression survival analysis.We found the 1-year survival in IPHP group was significantly longer than it in non-IPHP group (85.5% vs 73.8%, P = .027). and IPHP decreased mortality 1.8 times in 2-year course (OR = 0.556, P = .004). The incidence rate of total complications in IPHP group was similar to that in the Non-IPHP group (6.67% vs 7.46%, respectively; P = .718). We classified all patients into four groups, operation alone, operation + chemotherapy, operation + IPHP, and operation + IPHP + chemotherapy. The 1-year survival in the groups was 70.2%, 77.5%, 83.1%, and 93.5%, respectively (P = .001), compared with the group of operation alone, the 2-year mortality risk was decreased 1.76 times (OR = 0.569, P = .030) and 2.59 times (OR = 0.385, P = .022) in operation + IPHP group and operation + IPHP + chemotherapy group.Our results suggest that IPHP could contribute to improve survival of patients with gastric cancer. And the modality of operation + IPHP + chemotherapy is the optimal treatment modality for gastric cancer.
评估腹腔热灌注化疗(IPHP)在胃癌治疗中的价值。胃癌(GC)是一种预后较差的恶性肿瘤,近年来腹腔热灌注化疗在晚期胃癌(AGC)治疗中的应用取得了进展,但结果存在争议。2015年1月至2017年1月,我院外科对134例胃癌患者进行了腹腔热灌注化疗,其中130例为晚期胃癌患者,另1439例未接受腹腔热灌注化疗作为对照。在这项回顾性队列研究中,通过单因素分析、Kaplan-Meier法和Cox回归生存分析对人口统计学、围手术期数据和随访数据进行了分析。我们发现腹腔热灌注化疗组的1年生存率显著高于未接受腹腔热灌注化疗组(85.5%对73.8%,P = 0.027)。腹腔热灌注化疗在2年疗程中使死亡率降低了1.8倍(OR = 0.556,P = 0.004)。腹腔热灌注化疗组的总并发症发生率与未接受腹腔热灌注化疗组相似(分别为6.67%和7.46%;P = 0.718)。我们将所有患者分为四组:单纯手术组、手术+化疗组、手术+腹腔热灌注化疗组和手术+腹腔热灌注化疗+化疗组。各组的1年生存率分别为70.2%、77.5%、83.1%和93.5%(P = 0.001),与单纯手术组相比,手术+腹腔热灌注化疗组和手术+腹腔热灌注化疗+化疗组的2年死亡风险分别降低了1.76倍(OR = 0.569,P = 0.030)和2.59倍(OR = 0.385,P = 0.022)。我们的结果表明,腹腔热灌注化疗有助于提高胃癌患者的生存率。手术+腹腔热灌注化疗+化疗模式是胃癌的最佳治疗模式。