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对接受了细胞减灭术联合腹腔热灌注化疗(HIPEC)的胃肠道肿瘤患者的发病率进行评估。

The evaluation of morbidity in gastrointestinal tumor patients underwent cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (HIPEC).

作者信息

Aytin Yusuf Emre, Cakcak İbrahim Ethem, Sağıroğlu Tamer

机构信息

Department of General Surgery, Trakya University Faculty of Medicine, Edirne, Türkiye.

Department of General Surgery, Namık Kemal University Faculty of Medicine, Tekirdağ, Türkiye.

出版信息

Turk J Surg. 2023 Jan 6;39(1):17-26. doi: 10.47717/turkjsurg.2023.5706. eCollection 2023 Mar.

Abstract

OBJECTIVES

In this study, we aimed to determine the postoperative morbidity rate and identify demographic, clinical, and treatment-related variables that may be potential risk factors for morbidity in gastrointestinal tumor patients undergoing hyperthermic intraperitoneal chemotherapy (HIPEC) with or without cytoreductive surgery (CRS).

MATERIAL AND METHODS

In this retrospective study, 60 patients who had undergone HIPEC due to gastrointestinal tumor between October 2017 and December 2019 were included. Systemic toxicities were graded and evaluated according to the National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) version 3.0 criteria.

RESULTS

Mean age of the patients was 60.43 ± 12.83. Primary tumor localization was the stomach in 33 patients (55%), colon in 21 (35%), rectum in five (8.3%), and appendix in one patient (1.7%). PCI mean value was 9.51 ± 10.92. CC-0 was applied in 37 (61.7%) patients, CC-1 in 11 (18.3%), CC-2 in 6 (10%), and CC-3 in six patients (10%). Morbidity was observed in 50 (83.33%) of the 60 patients participating in the study according to NCI-CTCAE v3.0 classification. Mild morbidity rate was 46.6%, severe morbidity rate was 36.6%, and mortality rate was 11.66%. Enteric diversion application, length of stay in the ICU, and length of hospital stay were shown to have a statistically significant effect on the NCI-CTCAE morbidity score (p= 0.046, p= 0.004, p <0.001).

CONCLUSION

With proven beneficial effects on survival in patients with locally advanced gastrointestinal tumors, CRC and HIPEC are acceptable in these patients despite their increased morbidity and mortality rate. With new studies on this subject, morbidity and mortality rates may be reduced.

摘要

目的

在本研究中,我们旨在确定术后发病率,并识别可能是接受或未接受细胞减灭术(CRS)的热灌注腹腔化疗(HIPEC)的胃肠道肿瘤患者发病潜在危险因素的人口统计学、临床和治疗相关变量。

材料与方法

在这项回顾性研究中,纳入了2017年10月至2019年12月期间因胃肠道肿瘤接受HIPEC的60例患者。根据美国国立癌症研究所(NCI)不良事件通用术语标准(CTCAE)第3.0版标准对全身毒性进行分级和评估。

结果

患者的平均年龄为60.43±12.83岁。原发肿瘤定位在胃的有33例(55%),结肠21例(35%),直肠5例(8.3%),阑尾1例(1.7%)。PCI平均值为9.51±10.92。37例(61.7%)患者应用CC-0,11例(18.3%)应用CC-1,6例(共10%)应用CC-2,6例(共10%)应用CC-3。根据NCI-CTCAE v3.0分类,参与研究的60例患者中有50例(83.33%)出现并发症。轻度并发症发生率为46.6%,重度并发症发生率为36.6%,死亡率为11.66%。肠造口术的应用、在重症监护病房的住院时间和住院总时长对NCI-CTCAE并发症评分有统计学显著影响(p = 0.046,p = 0.004,p <0.001)。

结论

尽管发病率和死亡率有所增加,但CRS和HIPEC对局部晚期胃肠道肿瘤患者的生存具有已证实的有益效果,在这些患者中是可接受的。随着关于该主题的新研究开展,发病率和死亡率可能会降低。

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