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采用细胞减灭术加腹腔热灌注化疗治疗肉瘤病可实现长期生存——2例患者的病例报告

Long-term survival is possible using cytoreductive surgery plus HIPEC for sarcomatosis-Case report of 2 patients.

作者信息

Sugarbaker Paul H

机构信息

Program in Peritoneal Surface Malignancies, MedStar Washington Hospital Center, 106 Irving St., NW, Suite 3900, Washington, DC, 20010, USA.

出版信息

Int J Surg Case Rep. 2019;64:10-14. doi: 10.1016/j.ijscr.2019.09.009. Epub 2019 Sep 21.

Abstract

BACKGROUND

Sarcomatosis results from the dissemination of cells from an abdominal or pelvic primary sarcoma to the peritoneal surfaces. In most patients this is a lethal condition.

METHODS

The clinical and radiologic features of two patients with sarcomatosis were reviewed. Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC) were used for treatment. Current status of these two patients was available.

RESULTS

These two patients had a large extent of disease. In one, a myxoid sarcoma filled the pelvis. In another, all quadrants of the abdomen and pelvis were involved by peritoneal metastases from a uterine leiomyosarcoma. The grade of these two tumors was moderate and low. Surgical resection of all sarcomatosis was performed and this was followed by HIPEC. Clinical and radiologic follow-up at 37 and 58 months after complete cytoreduction show no evidence of disease.

CONCLUSION

An effort to identify patients with sarcomatosis who are predicted to have a complete cytoreduction should occur when these patients are evaluated. Patients with a complete resection and a sarcoma-specific HIPEC may have prolonged disease-free survival. No other treatments for these patients have been described.

摘要

背景

肉瘤病是由腹部或盆腔原发性肉瘤的细胞播散至腹膜表面所致。在大多数患者中,这是一种致命性疾病。

方法

回顾了两名肉瘤病患者的临床和影像学特征。采用细胞减灭术和腹腔内热化疗(HIPEC)进行治疗。这两名患者的当前状况均已知晓。

结果

这两名患者的疾病范围广泛。其中一名患者,黏液样肉瘤充满盆腔。另一名患者,子宫平滑肌肉瘤的腹膜转移累及腹部和盆腔的所有象限。这两个肿瘤的分级分别为中度和低度。对所有肉瘤病进行了手术切除,随后进行了HIPEC。在完全细胞减灭术后37个月和58个月的临床及影像学随访显示无疾病证据。

结论

在评估肉瘤病患者时,应努力识别预计能实现完全细胞减灭的患者。接受完全切除并进行肉瘤特异性HIPEC治疗的患者可能会延长无病生存期。尚未描述针对这些患者的其他治疗方法。

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