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术中腹腔内热化疗联合手术治疗晚期卵巢癌患者的疗效与安全性

Efficacy and safety of hyperthermic intraperitoneal intraoperative chemotherapy plus surgery in advanced ovarian cancer patients.

作者信息

Yanan Chang, Ting Liu, Li Cao Wei, Yaxin Xu, Hong Chen

机构信息

Obstetrics and Gynecology Department, The Fifth Hospital of Wuhan, China.

Obstetrics and Gynecology Department, Wuhan Yangtze River Shipping General Hospital, China.

出版信息

J Int Med Res. 2025 Sep;53(9):3000605251372415. doi: 10.1177/03000605251372415. Epub 2025 Sep 9.

Abstract

ObjectiveThis study aimed to evaluate the efficacy and safety of hyperthermic intraperitoneal intraoperative chemotherapy (HIPEC) in patients with advanced ovarian cancer.MethodsA total of 200 patients with advanced ovarian cancer were enrolled in this retrospective study and randomly allocated to two groups (research registry number: 11353). On the first day after abdominal closure, routine treatment was performed in the non-HIPEC group, whereas HIPEC was performed in the HIPEC group. The surgical outcomes, overall survival, progression-free survival, side effects, and quality of life of patients were compared between the two groups, and the risk factors for overall survival and progression-free survival were analyzed.ResultsThe basic information of the patients showed no significant difference between the two groups (p > 0.05). There was no significant difference in the time from surgery to first flatus, postoperative hospital stay, abdominal pain, bleeding, leakage, or other blood indices between the two groups (p>0.05); however, the symptoms of ileus and pelvic abscess appeared more frequently in the non-HIPEC group (p<0.05). HIPEC, tumor size, N stage, T stage, and vascular invasion were significant indicators, while HIPEC, tumor size, vascular invasion, N stage, and T stage were independent prognostic factors. The 3-year survival rate of the HIPEC group (42%) was higher than that of the non-HIPEC group (21%) (p<0.001). The progression-free survival curve of the HIPEC group was superior to that of the non-HIPEC group (p0.001), and the recurrence rate of the HIPEC group (25%) was lower than that of the non-HIPEC group (49%) (p0.001).ConclusionsHIPEC can reduce the possibility of perioperative complications such as intestinal obstruction and pelvic abscess, and the overall survival and progression-free survival curves were better in the HIPEC group.

摘要

目的

本研究旨在评估热灌注腹腔内术中化疗(HIPEC)在晚期卵巢癌患者中的疗效和安全性。

方法

本回顾性研究共纳入200例晚期卵巢癌患者,随机分为两组(研究注册号:11353)。在腹部闭合后的第一天,非HIPEC组进行常规治疗,而HIPEC组进行HIPEC治疗。比较两组患者的手术结果、总生存期、无进展生存期、副作用和生活质量,并分析总生存期和无进展生存期的危险因素。

结果

患者的基本信息在两组之间无显著差异(p>0.05)。两组在术后首次排气时间、术后住院时间、腹痛、出血、渗漏或其他血液指标方面无显著差异(p>0.05);然而,非HIPEC组肠梗阻和盆腔脓肿的症状出现频率更高(p<0.05)。HIPEC、肿瘤大小、N分期、T分期和血管侵犯是显著指标,而HIPEC、肿瘤大小、血管侵犯、N分期和T分期是独立的预后因素。HIPEC组的3年生存率(42%)高于非HIPEC组(21%)(p<0.001)。HIPEC组的无进展生存曲线优于非HIPEC组(p<0.001),HIPEC组的复发率(25%)低于非HIPEC组(49%)(p<0.001)。

结论

HIPEC可以降低围手术期肠梗阻和盆腔脓肿等并发症的发生可能性,且HIPEC组的总生存期和无进展生存期曲线更好。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c04e/12421004/6d129b439ad9/10.1177_03000605251372415-fig1.jpg

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