一项真实世界研究：常温术中腹腔内化疗是否如我们预期的那样有效？
A real-word study: is normothermic intraoperative intraperitoneal chemotherapy impactful as we expect?
作者信息
Jin Mengyao, Cao Wei, Chen Junjie, Xiong Maoming, Cao Guodong, Chen Bo
机构信息
Department of General Surgery, First Affiliated Hospital of Anhui Medical University, Hefei, China.
Department of Surgery, The People's Hospital of Hanshan County, Ma'anshan, China.
出版信息
Front Oncol. 2023 Jul 4;13:1172782. doi: 10.3389/fonc.2023.1172782. eCollection 2023.
BACKGROUND
Patients with gastric cancer have a poor prognosis. Currently, intraperitoneal chemotherapy has been considered a therapeutic option to improve prognosis due to its appealing theoretical rationales. But there is no consensus on the choice of chemotherapeutic agents used in intraperitoneal chemotherapy for gastric cancer. The real-world efficacy of applying intraoperative chemotherapy in gastric cancer still remains undefined.
METHODS
Patients with gastric cancer who underwent radical gastrectomy at the Gastrointestinal Department of The First Affiliated Hospital of Anhui Medical University between 2012 and 2019 were enrolled in this study. Patients were divided into two groups based on whether they received intraperitoneal chemotherapy. The t-test (mean of two samples) was conducted to compare the difference in measurement data between the two groups, and the chi-square test was used to compare the difference in count data. Kaplan-Meier method with log-rank test was performed to analyze the overall survival of patients. Kaplan-Meier method with log-rank test was also performed in various subgroups to respectively compare the survival of patients. Multivariate Cox analysis was performed to analyze the prognosis factors of these patients.
RESULTS
A total of 1253 patients were included in the final analysis, in which 861 patients received intraperitoneal chemotherapy and 352 not received intraperitoneal chemotherapy. The clinicopathological features of the participants in the two groups were comparable. There was no significant difference between the two groups in overall survival ( > 0.05). Consistently, no significant difference was found between the two groups in each subgroup ( > 0.05). The multivariate Cox analysis demonstrated that only age, BMI, pathological type, TNM stage, and differentiation grade were independent risk factors of survival.
CONCLUSION
Intraoperative intraperitoneal chemotherapy usage did not improve survival in patients with gastric cancer undergoing radical gastrectomy.
背景
胃癌患者预后较差。目前，由于其具有吸引人的理论依据，腹腔内化疗已被视为改善预后的一种治疗选择。但对于胃癌腹腔内化疗所用化疗药物的选择尚无共识。胃癌术中应用化疗的真实疗效仍不明确。
方法
纳入2012年至2019年在安徽医科大学第一附属医院胃肠外科接受根治性胃切除术的胃癌患者。根据是否接受腹腔内化疗将患者分为两组。采用t检验（两个样本的均值）比较两组测量数据的差异，采用卡方检验比较计数数据的差异。采用Kaplan-Meier法和对数秩检验分析患者的总生存期。在各个亚组中也采用Kaplan-Meier法和对数秩检验分别比较患者的生存期。进行多因素Cox分析以分析这些患者的预后因素。
结果
最终分析共纳入1253例患者，其中861例接受腹腔内化疗，352例未接受腹腔内化疗。两组参与者的临床病理特征具有可比性。两组总生存期无显著差异（P>0.05）。同样，各亚组两组间均未发现显著差异（P>0.05）。多因素Cox分析表明，只有年龄、BMI、病理类型、TNM分期和分化程度是生存的独立危险因素。
结论
对于接受根治性胃切除术的胃癌患者，术中腹腔内化疗的使用并未改善生存情况。
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