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结直肠癌腹膜转移患者行细胞减灭术和腹腔热灌注化疗的短期疗效:一项多中心研究。

Short-term outcome of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy used as treatment of colo-rectal carcinomatosis: a multicentric study.

机构信息

Department of Human Pathology, Peritoneal Surface Malignancy and Soft Tissue Sarcoma Program, University of Messina, Via Consolare Valeria, 98125, Messina, Italy.

Department of Clinical and Experimental Medicine, University of Messina, Via Consolare Valeria, 98125, Messina, Italy.

出版信息

Updates Surg. 2020 Mar;72(1):163-170. doi: 10.1007/s13304-019-00691-8. Epub 2019 Nov 15.

DOI:10.1007/s13304-019-00691-8
PMID:31729630
Abstract

The aim of this study is to assess the morbidity and mortality related to cytoreductive surgery (CRS) plus hyperthermic intraperitoneal chemotherapy (HIPEC) in patients with colo-rectal carcinomatosis. A retrospective multi-institutional study from seven Italian Centers was performed. One hundred and seventy-two patients, submitted to cytoreductive surgery (CRS) plus hyperthermic intraperitoneal chemotherapy (HIPEC) to treat carcinomatosis of colorectal origin, were recorded. Postoperative morbidity was evaluated in accordance with the National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) v4.03. Post-operative mortality was evaluated as patients' death within 60 days from surgical procedures. Predictors of morbidity were evaluated with univariate and multivariate analyses. Post-operative morbidity occurred in 83 patients (48.3%): grades 1-2 in 29 cases (16.9%), and grades 3-4 in 54 (31.4%). Mortality occurred in four cases (2.3%). Number of anastomoses (OR 1.45; 95% CI 1.05-2.00; p = 0.024), number of blood transfusions (OR 1.31; 95% CI 1.11-1.54; p = 0.001) and chemotherapy regimen [Oxaliplatin (OX): OR 2.87; 95% CI 1.22-6.75; p = 0.015] remained, in multivariate analysis, in a statistically significant correlation with overall morbidity. The only variable that was proven to have statistically significant correlation with 3-4 morbidity was the number of blood transfusions (OR 1.25; 95% CI 1.07-1.46; p = 0.005). Morbidity and mortality do not preclude the use of CRS plus HIPEC in the treatment of peritoneal carcinomatosis of colorectal origin.

摘要

本研究旨在评估结直肠肿瘤腹膜转移患者行细胞减灭术(CRS)加腹腔热灌注化疗(HIPEC)的发病率和死亡率。对来自意大利 7 家中心的多机构回顾性研究进行了分析。记录了 172 名接受细胞减灭术(CRS)加腹腔热灌注化疗(HIPEC)治疗结直肠来源肿瘤腹膜转移的患者。根据国家癌症研究所(NCI)常见不良事件术语标准(CTCAE)v4.03 评估术后发病率。术后死亡率评估为手术后 60 天内患者死亡。使用单变量和多变量分析评估发病率的预测因素。83 例患者(48.3%)发生术后并发症:29 例(16.9%)为 1-2 级,54 例(31.4%)为 3-4 级。4 例(2.3%)死亡。吻合口数量(OR 1.45;95%CI 1.05-2.00;p=0.024)、输血次数(OR 1.31;95%CI 1.11-1.54;p=0.001)和化疗方案[奥沙利铂(OX):OR 2.87;95%CI 1.22-6.75;p=0.015]在多变量分析中与总体发病率呈统计学显著相关。只有输血次数(OR 1.25;95%CI 1.07-1.46;p=0.005)与 3-4 级发病率有统计学显著相关性。发病率和死亡率并不排除 CRS 加 HIPEC 在治疗结直肠来源腹膜转移中的应用。

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