晚期和复发性卵巢癌细胞减灭术和腹腔热灌注化疗后胸腔积液的风险因素。

Risk factors of pleural effusion after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in late-stage and recurrent ovarian cancer.

机构信息

Department of Obstetrics and Gynecology, Beijing Shijitan Hospital, Capital Medical University, Beijing, China.

Department of Peritoneal Cancer Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing, China.

出版信息

Ann Palliat Med. 2021 Jan;10(1):385-391. doi: 10.21037/apm-20-2334.

DOI:10.21037/apm-20-2334

PMID:33545771

Abstract

BACKGROUND

Pleural effusion (PE) is one of the most common complications of advanced recurrent ovarian cancer. However, no studies have revealed the risk factors for PE after surgery. The purpose of this study is to observe the incidence and risk factors of PE after cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) in patients with late-stage and recurrent ovarian cancer.

METHODS

A retrospective analysis of 77 patients with late-stage and recurrent ovarian cancer after CRS + HIPEC was conducted. According to the presence of PE within 7 days after operation, two groups were formed. The basic information, surgical process, and laboratory examinations of the two groups were analyzed and compared to conduct a regression analysis.

RESULTS

The incidence of postoperative PE was 57.1% (44/77 patients). Among these patients, the prevalence of grade I-II and grade III-IV PE was 42.8% (33/77 patients) and 14.3% (11/77 patients), respectively. There were statistically significant differences between the two groups in terms of preoperative PE, the duration of surgery, intraoperative blood loss, postoperative level of albumin, intestinal involvement, and diaphragmatic involvement. Among these, preoperative PE and diaphragmatic involvement were identified as independent risk factors of postoperative PE.

CONCLUSIONS

Patients with late-stage and recurrent ovarian cancer invariably develop postoperative PE after CRS + HIPEC. Preoperative PE and diaphragmatic involvement are independent risk factors of postoperative PE. It is estimated that the incidence of postoperative PE among patients with these two independent risk factors is approximately 100%. Hence, we should promote the prevention and treatment of PE to improve its prognosis.

摘要

背景

胸腔积液（PE）是晚期复发性卵巢癌最常见的并发症之一。然而，目前尚无研究揭示术后发生 PE 的危险因素。本研究旨在观察晚期复发性卵巢癌患者行细胞减灭术（CRS）加腹腔热灌注化疗（HIPEC）后发生 PE 的发生率及危险因素。

方法

对 77 例行 CRS+HIPEC 的晚期复发性卵巢癌患者进行回顾性分析。根据术后 7 天内是否发生 PE 将患者分为两组，分析比较两组患者的基本信息、手术过程和实验室检查，进行回归分析。

结果

术后发生 PE 的患者占 57.1%（44/77 例），其中Ⅰ-Ⅱ级和Ⅲ-Ⅳ级 PE 的发生率分别为 42.8%（33/77 例）和 14.3%（11/77 例）。两组患者术前 PE、手术时间、术中出血量、术后白蛋白水平、肠管累及和膈肌累及差异均有统计学意义，其中术前 PE 和膈肌累及是术后发生 PE 的独立危险因素。