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肝动脉灌注泵治疗的实施:单中心真实世界经验

Implementation of Hepatic Artery Infusion Pump Therapy: Real-World Single-Center Experience.

作者信息

Connor Chick Robert, Ruff Samantha M, Monasterio Julia, Neilson Taylor, Tsai Susan, Ejaz Aslam, Tsung Allan, Kim Alex C

机构信息

Division of Surgical Oncology, The James Cancer Hospital and Solove Research Institute, The Ohio State University, Columbus, Ohio, USA.

Department of Surgery, University of Virginia, Charlottesville, Virgina, USA.

出版信息

J Surg Oncol. 2025 Feb;131(2):212-219. doi: 10.1002/jso.27859. Epub 2024 Sep 6.

Abstract

BACKGROUND AND OBJECTIVES

Hepatic artery infusion pump (HAIP) therapy is an available option at highly specialized centers to treat unresectable liver tumors (e.g., colorectal liver metastases [CRLM]). This study describes the safety and outcomes of HAIP program implementation at an academic-based cancer center.

METHODS

Patients who underwent HAIP placement (2021-2023) were included. Categorical and continuous variables were compared using Chi-square and Kruska-Wallis tests, respectively. Survival and variables associated with survival were calculated using the Kaplan-Meier method and Cox proportional hazards model, respectively.

RESULTS

Of the 26 HAIP procedures for unresectable CRLM, four were done as adjuvant therapy. Median duration of HAIP therapy was 9.2 months and four patients subsequently underwent hepatectomy. Complication rate was 37.5%, with biliary complication rate of 23.1%. Median overall survival (OS) from date of diagnosis was 55.2 months. Concurrent primary tumor resection was associated with inferior OS (p = 0.030). Multivariable regression did not identify independent predictors of OS. Progression-free survival from time of HAIP placement was 7.8 months.

CONCLUSIONS

HAIP placement was technically successful in most patients with an acceptable complication rate. Survival outcomes were comparable with those described in the literature for HAIP therapy in combination with systemic therapy. The significant difference in outcomes for those with concurrent colectomy warrants further investigation.

摘要

背景与目的

肝动脉灌注泵(HAIP)治疗是高度专业化中心治疗不可切除肝肿瘤(如结直肠癌肝转移[CRLM])的一种可行选择。本研究描述了在一家学术型癌症中心实施HAIP方案的安全性和结果。

方法

纳入2021年至2023年接受HAIP植入的患者。分别使用卡方检验和克鲁斯卡尔 - 沃利斯检验比较分类变量和连续变量。分别使用Kaplan - Meier法和Cox比例风险模型计算生存率及与生存相关的变量。

结果

在26例针对不可切除CRLM的HAIP手术中,4例作为辅助治疗。HAIP治疗的中位持续时间为9.2个月,4例患者随后接受了肝切除术。并发症发生率为37.5%,胆道并发症发生率为23.1%。从诊断日期起的中位总生存期(OS)为55.2个月。同期进行原发性肿瘤切除与较差的OS相关(p = 0.030)。多变量回归未确定OS的独立预测因素。从HAIP植入时间起的无进展生存期为7.8个月。

结论

HAIP植入在大多数患者中技术上成功,并发症发生率可接受。生存结果与文献中描述的HAIP治疗联合全身治疗的结果相当。同期进行结肠切除术患者的结果存在显著差异,值得进一步研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c04e/12035665/66ab2ea45cfb/JSO-131-212-g003.jpg

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