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减瘤手术联合腹腔内热灌注化疗治疗恶性腹膜间皮瘤的价值

Value of cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy to treat malignant peritoneal mesothelioma.

作者信息

Wang Tongfei, Li Haitao, Ye Biaofei, Zhang Da

机构信息

Department of Oncology, Xi'an No. 3 Hospital, The Affiliated Hospital of Northwest University Xi'an, Shaanxi, China.

Department of Oncological Surgery, Xi'an No. 3 Hospital, The Affiliated Hospital of Northwest University Xi'an, Shaanxi, China.

出版信息

Am J Transl Res. 2021 Sep 15;13(9):10712-10720. eCollection 2021.

Abstract

OBJECTIVE

To investigate the clinical efficacy of cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) for treating malignant peritoneal mesothelioma (MPM) and to assess the impact of this approach on patient prognosis.

METHODS

A retrospective analysis of 44 patients with MPM was performed. The control group (CNG, N = 23) was treated with CRS combined with postoperative intraperitoneal (IP) chemotherapy, while the observation group (OG, N = 21) was treated with CRS combined with HIPEC. The treatment efficacy, volume of blood loss, operation time, postoperative length of stay, and 3-year survival rate (SR) were compared, and the factors affecting the prognosis of MPM patients were analyzed by multivariate analysis.

RESULTS

The OG showed decreased volume of blood loss and operation time, while also showing increased overall treatment efficacy compared with the CNG. The SR in the OG was 65.22% compared with a rate of 33.33% in the CNG, and the 3-year SR in the OG was significantly higher than that in the CNG. Multivariate analysis revealed that tumor-node-metastasis (TNM) stage, Eastern Cooperative Oncology Group (ECOG) score, and treatment modality were independent risk factors for the prognosis of MPM patients.

CONCLUSION

CRS combined with HIPEC for MPM has a favorable treatment efficacy and prolongs the survival of MPM patients. Additionally, TNM stage, ECOG score, and treatment modality are independent risk factors for the prognosis of MPM patients.

摘要

目的

探讨减瘤手术(CRS)联合腹腔内热灌注化疗(HIPEC)治疗恶性腹膜间皮瘤(MPM)的临床疗效,并评估该方法对患者预后的影响。

方法

对44例MPM患者进行回顾性分析。对照组(CNG,N = 23)采用CRS联合术后腹腔内(IP)化疗,观察组(OG,N = 21)采用CRS联合HIPEC。比较两组的治疗效果、失血量、手术时间、术后住院时间和3年生存率(SR),并通过多因素分析MPM患者预后的影响因素。

结果

与CNG组相比,OG组失血量和手术时间减少,总体治疗效果提高。OG组的SR为65.22%,而CNG组为33.33%,OG组的3年SR显著高于CNG组。多因素分析显示,肿瘤-淋巴结-转移(TNM)分期、东部肿瘤协作组(ECOG)评分和治疗方式是MPM患者预后的独立危险因素。

结论

CRS联合HIPEC治疗MPM具有良好的治疗效果,可延长MPM患者的生存期。此外,TNM分期、ECOG评分和治疗方式是MPM患者预后的独立危险因素。

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