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细胞减灭术与细胞减灭术加腹腔热灌注化疗治疗腹膜癌转移的疗效比较:倾向评分匹配分析。

Comparison of the outcomes of cytoreductive surgery versus surgery plus hyperthermic intraperitoneal chemotherapy for peritoneal carcinomatosis: a propensity score matching analysis.

机构信息

Department of General Surgery, Zhujiang Hospital, Southern Medical University, No. 253, Industrial Avenue, Haizhu District, Guangzhou, 510282, Guangdong, China.

出版信息

Surg Endosc. 2021 Jun;35(6):2789-2796. doi: 10.1007/s00464-020-07712-3. Epub 2020 Jul 6.

Abstract

BACKGROUND

Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) are effective treatment options for selected patients with peritoneal carcinomatosis (PC). We compared the short-term outcomes of surgery plus HIPEC and CRS alone for PC.

METHODS

We retrospectively examined patients who underwent CRS-HIPEC for PC at a single center from 2014 to 2019 using the Chinese CRS-HIPEC patient database at our institution. Patients were divided into two groups: surgery plus HIPEC (450) and surgery alone (200). A 1:1 propensity score matching (PSM) analysis was performed. The postoperative outcomes, mortality, and length of hospital stay were compared between the surgery plus HIPEC and CRS alone groups.

RESULTS

Propensity scoring generated 162 pairs. There was no statistically significant difference in the 30-day mortality rate between the groups (0% vs 0%, P = 1.000), and the morbidity rates were similar in both groups (7.4% vs 8.0%, P = 0.835). The surgery plus HIPEC group had a longer operative time (247.81 ± 64.70 vs 184.55 ± 29.56, P ≤ 0.001) and a slightly longer postoperative hospital stay (14.64 ± 5.24 vs 12.59 ± 3.76, P ≤ 0.001). No other baseline characteristics were significantly different.

CONCLUSIONS

Surgery plus HIPEC is feasible for select patients and is associated with prolonged surgery times and prolonged hospital stays, and there is no significant difference in mortality rates or postoperative outcomes.

摘要

背景

细胞减灭术(CRS)和腹腔热灌注化疗(HIPEC)是治疗腹膜转移癌(PC)的有效方法。我们比较了手术联合 HIPEC 和单独 CRS 治疗 PC 的短期结果。

方法

我们使用我们机构的中国 CRS-HIPEC 患者数据库,回顾性地检查了 2014 年至 2019 年期间在一个中心接受 CRS-HIPEC 治疗 PC 的患者。患者分为两组:手术联合 HIPEC(450 例)和单独手术(200 例)。进行了 1:1 倾向评分匹配(PSM)分析。比较了手术联合 HIPEC 和单独 CRS 组之间的术后结果、死亡率和住院时间。

结果

倾向评分生成了 162 对。两组 30 天死亡率无统计学差异(0% vs 0%,P=1.000),两组发病率相似(7.4% vs 8.0%,P=0.835)。手术联合 HIPEC 组的手术时间较长(247.81±64.70 与 184.55±29.56,P≤0.001),术后住院时间略长(14.64±5.24 与 12.59±3.76,P≤0.001)。其他基线特征无显著差异。

结论

手术联合 HIPEC 对某些患者是可行的,与手术时间延长和住院时间延长相关,但死亡率或术后结果无显著差异。

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