Department of Hepatobiliary Surgery, Hunan Research Center of Biliary Disease, Hunan Provincial People's Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, Hunan Province, China.
Biliary Disease Research Laboratory of Hunan Provincial People's Hospital, Key Laboratory of Hunan Normal University, Changsha, Hunan Province, China.
Can J Gastroenterol Hepatol. 2021 Oct 8;2021:4006786. doi: 10.1155/2021/4006786. eCollection 2021.
The aim of the study was to investigate the effect of hyperthermic intraperitoneal perfusion chemotherapy (HIPEC) combined with radical surgery and capecitabine on stage III gallbladder cancer.
Seventy-eight patients with stage III gallbladder cancer treated in our hospital between December 2015 and April 2019 were retrospectively enrolled. Depending on the treatment approach, the patients were divided into the control group (radical surgery and capecitabine) and the HIPEC group (hyperthermic intraperitoneal perfusion chemotherapy combined with radical surgery and capecitabine). The patients were followed up by outpatient or through telephone until April 1, 2020. SPSS 19.0 software was applied for data analysis. Survival analysis was performed using the Kaplan-Meier method and parallel log-rank test.
There were 43 cases in the control group and 35 cases in the HIPEC group. There were no significant differences in operation time, lymph node metastasis, microvascular infiltration, and nerve invasion; there was no significant difference in postoperative complications between the two groups ( > 0.05). The average hospitalization time of the HIPEC group was 23.0 ± 6.9 days, which was longer than the 20.0 ± 5.8 days of the control group ( < 0.05). The body temperatures of HIPEC group patients at 0 h and 6 h after operation were higher than those of patients in the control group ( < 0.05); however, the body temperature of the two groups gradually became the same at 12-24 h after operation. There was no liver and kidney damage in the two groups after surgery. The platelets in the HIPEC group were less than those in the control group ( < 0.05). The median survival time of HIPEC was 19.2 months, which was longer than 15.3 months in the control group. The 1-year survival rates of the two groups were 91.43% vs. 76.71%, and the 2-year survival rates were 26.29% vs. 17.53%, respectively ( < 0.05).
HIPEC combined with radical surgery and capecitabine for stage III gallbladder cancer can effectively prolong survival time without increasing surgery-related complications.
本研究旨在探讨腹腔热灌注化疗（HIPEC）联合根治性手术和卡培他滨治疗 III 期胆囊癌的效果。
回顾性分析 2015 年 12 月至 2019 年 4 月期间在我院接受治疗的 78 例 III 期胆囊癌患者的临床资料。根据治疗方式的不同，将患者分为对照组（根治性手术和卡培他滨）和 HIPEC 组（腹腔热灌注化疗联合根治性手术和卡培他滨）。通过门诊或电话随访患者至 2020 年 4 月 1 日。采用 SPSS 19.0 软件进行数据分析。采用 Kaplan-Meier 法和并行对数秩检验进行生存分析。
对照组 43 例，HIPEC 组 35 例。两组手术时间、淋巴结转移、微血管浸润和神经侵犯比较，差异无统计学意义（>0.05）；两组术后并发症比较，差异无统计学意义（>0.05）。HIPEC 组平均住院时间为 23.0±6.9 天，长于对照组的 20.0±5.8 天（<0.05）。HIPEC 组患者术后 0 h 和 6 h 的体温高于对照组（<0.05）；但术后 12-24 h 时，两组体温逐渐相同。两组术后均未出现肝肾功能损伤。HIPEC 组血小板计数低于对照组（<0.05）。HIPEC 组中位生存时间为 19.2 个月，长于对照组的 15.3 个月。两组 1 年生存率分别为 91.43%和 76.71%，2 年生存率分别为 26.29%和 17.53%（<0.05）。
腹腔热灌注化疗联合根治性手术和卡培他滨治疗 III 期胆囊癌能有效延长生存时间，且不会增加手术相关并发症。
