Yang Zhongyin, Li Chen, Liu Wentao, Zheng Yanan, Zhu Zhenglun, Hua Zichen, Ni Zhentian, Lu Sheng, Yan Min, Yan Chao, Zhu Zhenggang
Department of General Surgery, Gastrointestinal Surgery, Shanghai Key Laboratory of Gastric Neoplasms, Shanghai Institute of Digestive Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
Chin J Cancer Res. 2020 Aug;32(4):497-507. doi: 10.21147/j.issn.1000-9604.2020.04.07.
Intraperitoneal (IP) chemotherapy through subcutaneous port is an effective treatment for gastric cancer (GC) patients with peritoneal metastasis (PM). The objective of this study is to assess the port complications and risk factors for complications in GC patients with PM.
In retrospective screening of 301 patients with subcutaneous ports implantation, 249 GC patients with PM who received IP chemotherapy were screened out for analysis. Port complications and risk factors for complications were analyzed.
Of the 249 analyzed patients, 57 (22.9%) experienced port complications. Subcutaneous liquid accumulation (42.1%) and infection (28.1%) were the main complications, and other complications included port rotation (14.1%), wound dehiscence (12.3%), inflow obstruction (1.7%) and subcutaneous metastasis (1.7%). The median interval between port implantation and occurrence of complications was 3.0 months. Eastern Cooperative Oncology Group (ECOG) performance status [odds ratio (OR), 1.74; 95% confidence interval (95% CI), 1.12-2.69], albumin (OR, 3.67; 95% CI, 1.96-6.86), implantation procedure optimization (OR, 0.33; 95% CI, 0.18-0.61) and implantation groups (OR, 0.37; 95% CI, 0.20-0.69) were independent risk factors for port complications (P<0.05). ECOG performance status was the only factor that related to the grades of port complications (P=0.016).
Port complications in GC patients who received IP chemotherapy are manageable. ECOG performance status, albumin, implantation procedure and implantation group are independent risk factors for port complications in GC patients with PM.
通过皮下端口进行腹腔内（IP）化疗是治疗伴有腹膜转移（PM）的胃癌（GC）患者的一种有效方法。本研究的目的是评估伴有PM的GC患者的端口并发症及并发症的危险因素。
在对301例行皮下端口植入术的患者进行回顾性筛查时，筛选出249例接受IP化疗的伴有PM的GC患者进行分析。分析端口并发症及并发症的危险因素。
在249例分析患者中，57例（22.9%）出现端口并发症。皮下积液（42.1%）和感染（28.1%）是主要并发症，其他并发症包括端口旋转（14.1%）、伤口裂开（12.3%）、流入道梗阻（1.7%）和皮下转移（1.7%）。端口植入与并发症发生之间的中位间隔时间为3.0个月。东部肿瘤协作组（ECOG）体能状态[比值比（OR），1.74；95%置信区间（95%CI），1.12 - 2.69]、白蛋白（OR，3.67；95%CI，1.96 - 6.86）、植入操作优化（OR，0.33；95%CI，0.18 - 0.61）和植入组（OR，0.37；95%CI，0.20 - 0.69）是端口并发症的独立危险因素（P<0.05）。ECOG体能状态是唯一与端口并发症分级相关的因素（P = 0.016）。
接受IP化疗的GC患者的端口并发症是可控的。ECOG体能状态、白蛋白、植入操作和植入组是伴有PM的GC患者端口并发症的独立危险因素。
