中国 10 年治疗阑尾黏液性肿瘤腹膜假黏液瘤伴不完全肿瘤细胞减灭术后腹腔热灌注化疗的经验
Hyperthermic intraperitoneal chemotherapy in patients with incomplete cytoreduction for appendiceal pseudomyxoma peritonei: a 10-year treatment experience in China.
机构信息
Department of Myxoma, Aerospace Center Hospital, Beijing, 100049, China.
Department of Gastrointestinal Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China.
出版信息
Orphanet J Rare Dis. 2024 Jan 4;19(1):8. doi: 10.1186/s13023-023-02995-w.
BACKGROUND
To explore the application value of hyperthermic intraperitoneal chemotherapy (HIPEC) in patients with incomplete cytoreduction for appendiceal pseudomyxoma peritonei (PMP).
METHODS
We retrospectively analyzed the clinical data of 526 patients with incomplete cytoreduction for appendiceal PMP to discover its prognostic factors, and the therapeutic value of HIPEC.
RESULTS
The 5-year and 10-year overall survival rates of patients after cytoreductive surgery (CRS) treated with HIPEC were significantly higher than those without HIPEC (5y-OS: 58% vs. 48%, 10y-OS: 37% vs. 16%, P = 0.032). The median progression-free survival (PFS) following CRS was 20 months, with a 20% 3-year PFS. The median PFS following CRS + HIPEC was 33 months, with a 60% 3-year PFS (P = 0.000). Univariate analysis indicated that HIPEC, gender, completeness of cytoreduction (CCR) and pathological grade had statistical difference. Multivariate analysis showed that CRS without HIPEC and high pathological grade were independent risk factors for poor prognosis and rapid tumor progression.
CONCLUSIONS
HIPEC may prolong the survival in patients with incomplete cytoreduction for low-grade appendiceal PMP. High pathological grade indicates poor survival and rapid tumor progression.
背景
探讨腹腔内热灌注化疗（HIPEC）在阑尾假性黏液瘤腹膜种植（PMP）不完全减瘤患者中的应用价值。
方法
我们回顾性分析了 526 例不完全减瘤的阑尾 PMP 患者的临床资料，以发现其预后因素和 HIPEC 的治疗价值。
结果
接受细胞减灭术（CRS）联合 HIPEC 治疗的患者 5 年和 10 年总生存率明显高于未接受 HIPEC 治疗的患者（5y-OS：58% vs. 48%，10y-OS：37% vs. 16%，P=0.032）。CRS 后的中位无进展生存期（PFS）为 20 个月，3 年 PFS 为 20%。CRS+HIPEC 后的中位 PFS 为 33 个月，3 年 PFS 为 60%（P=0.000）。单因素分析表明，HIPEC、性别、减瘤完全程度（CCR）和病理分级有统计学差异。多因素分析显示，未行 HIPEC 的 CRS 和高病理分级是预后不良和肿瘤快速进展的独立危险因素。
结论
HIPEC 可能延长低级别阑尾 PMP 不完全减瘤患者的生存时间。高病理分级提示生存不良和肿瘤快速进展。
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