细胞减灭术和腹腔热灌注化疗在子宫癌所致腹膜癌病中是否有作用？

Is There a Role for Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy in Peritoneal Carcinomatosis Due to Uterine Cancer?

作者信息

Düzgün Özgül, Kalin Murat

机构信息

Department of Surgical Oncology, Istanbul Ümraniye Training and Research Hospital, Health Sciences University, 34766 İstanbul, Turkey.

出版信息

J Pers Med. 2022 Oct 30;12(11):1790. doi: 10.3390/jpm12111790.

DOI:10.3390/jpm12111790

PMID:36579503

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9693328/

Abstract

BACKGROUND

Uterine canceris one of the most common pelvic tumors in females. Advanced stage uterine cancer only represents 15% of newly diagnosed cases; however, they are related with poor prognosis. Our aim was to analyze the benefits of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in peritoneal carcinomatosis due to uterine cancer.

METHODS

At the Istanbul Umraniye Training and Research Hospital, Surgical Oncology Clinic, morbidity, overall survival and survival without progression were analyzed over the 5-year follow up. Twenty-two cases who had undergone cytoreductive surgery and hyperthermic intraperitoneal chemotherapy due to uterine-peritoneal carcinomatosis were included in this study. Cases were followed up in terms of postoperative morbidity-mortality, disease-free survival and overall survival. The cut off value for the peritoneal carcinomatosis index score was set at 15. Intraperitoneal chemotherapy consisting of cisplatin and doxorubicin was applied to all patients for 60 min after the suturation of the abdomen.

RESULTS

Median age of the patients was 64.6 (43-72). Average PCI score was 12.8 (3-15). CC score was 0 in 16 (72.7%) cases, 1 in 3 cases and 2 in 3 cases. Of these patients, 12 of them were previously operated upon. Median stay at the hospital was 13.1 days. No major complications due to chemotherapy were reported. A Clavien-Dindo Grade 3 complication was observed in seven (31.8%) patients. Mortality was not observed in patients during their stay at the hospital. The 5-year disease-free survival and overall survival rates were 36.8 (36%) months and 45.3 (57%) months, respectively.

CONCLUSIONS

We think that due to longer disease-free survival and overall survival, cytoreductive surgery and hyperthermic intraperitoneal chemotherapy should be preferred in peritoneal carcinomatosis due to uterine cancer patients having low peritoneal carcinomatosis index scores and manageable complication rates. However, prospective randomizedtrials with a high number of cases are needed for this subject.

摘要

背景

子宫癌是女性最常见的盆腔肿瘤之一。晚期子宫癌仅占新诊断病例的15%；然而，它们与预后不良有关。我们的目的是分析细胞减灭术和热灌注化疗在子宫癌腹膜转移癌中的益处。

方法

在伊斯坦布尔乌尔拉尼耶培训和研究医院外科肿瘤诊所，对5年随访期间的发病率、总生存率和无进展生存率进行了分析。本研究纳入了22例因子宫-腹膜转移癌接受细胞减灭术和热灌注化疗的患者。对患者进行术后发病率-死亡率、无病生存期和总生存期的随访。腹膜转移癌指数评分的截断值设定为15。所有患者在腹部缝合后接受由顺铂和阿霉素组成的腹腔化疗60分钟。

结果

患者的中位年龄为64.6岁（43 - 72岁）。平均PCI评分为12.8（3 - 15）。CC评分为0的有16例（72.7%），评分为1的有3例，评分为2的有3例。这些患者中，有12例曾接受过手术。中位住院时间为13.1天。未报告化疗引起的重大并发症。7例（31.8%）患者出现Clavien-Dindo 3级并发症。患者住院期间未观察到死亡。5年无病生存率和总生存率分别为36.8（36%）个月和45.3（57%）个月。