Complications and Toxicities After Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy
Complications and Toxicities After Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy
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DOI：
10.1245/s10434-012-2853-x
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发表时间：
2013-04-01
影响因子：
3.7
通讯作者：
Fuzun, Mehmet
中科院分区：
文献类型：
--
作者：
Canda, Aras Emre;Sokmen, Selman;Fuzun, Mehmet
2007年9月至2012年3月，我们对115例腹膜癌转移（PC）患者行118次腹腔内温热化疗（HIPEC）和肿瘤细胞减灭术（CRS），观察其围手术期并发症、毒副反应、死亡率及疗效。根据美国国家癌症研究所（NCI）不良事件通用术语标准（CTCAE）3.0版标准对全身毒性进行分级，并从前瞻性收集的数据库中进行分析。患者的平均年龄为53.4岁（范围，20-82）; 76.3%为女性。53.4%的患者与原发癌同时发生，41.5%的患者与原发癌异时发生，5.1%的患者与原发癌复发。53.4%的患者接受的PCI为千分之一日元15，68.5%的患者实现了CC-0细胞减少。观察到9例（7.6%）患者围手术期死亡。46例（39.0%）患者共观察到98例并发症，4例患者因围手术期手术并发症接受了6次再次手术。我们在25.4%的患者中观察到毒性，在18.6%的患者中观察到肾毒性，在13.6%的患者中观察到血液毒性。年龄、性别、PCI和CC评分、原发肿瘤来源、毒副反应和手术并发症的发生率无显著差异。手术时间延长导致并发症和/或毒性发生率增加（P < 0.01），肿瘤细胞减灭术联合HIPEC是治疗腹膜表面恶性肿瘤的一种有效的联合治疗策略，并发症和毒性发生率可接受。
The purpose of our study was to evaluate the perioperative complications, toxicity, mortality rates after cytoreductive surgery (CRS), and effects of hyperthermic intraperitoneal chemotherapy (HIPEC) used in the treatment of peritoneal surface malignancies.Between September 2007 and March 2012, we performed 118 CRS and HIPEC with the closed abdominal technique on 115 patients with peritoneal carcinomatosis (PC). Systemic toxicities were graded according to the National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) version 3.0 criteria and were analyzed from a prospectively collected database.The mean age of patients was 53.4 (range, 20-82) years; 76.3 % were female. PC was synchronous to primary cancer in 53.4 % of patients, metachronous in 41.5 %, and recurrent in 5.1 % of the patients. PCI was a parts per thousand yen15 in 53.4 % of the patients, and CC-0 cytoreduction was achieved in 68.5 % of the patients. Perioperative mortality was observed in 9 (7.6 %) patients. A total of 98 complications were observed in 46 (39.0 %) patients, and 4 patients underwent 6 reoperations for perioperative surgical complications. We observed toxicity in 25.4 % of the patients, nephrotoxicity in 18.6 %, and hematological toxicity in 13.6 % of patients. No significant difference was observed among age, gender, PCI and CC scores, origin of the primary tumor, and occurrence of toxicity and surgical complications. Prolonged operation times resulted in higher complication and/or toxicity rates (P < 0.01).Cytoreductive surgery and HIPEC is a combined treatment strategy for peritoneal surface malignancies with acceptable complication and toxicity rates.