Factors predicting survival after intraperitoneal hyperthermic chemotherapy with mitomycin C after cytoreductive surgery for patients with peritoneal carcinomatosis
Factors predicting survival after intraperitoneal hyperthermic chemotherapy with mitomycin C after cytoreductive surgery for patients with peritoneal carcinomatosis
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DOI：
10.1001/archsurg.138.1.26
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发表时间：
2003-01-01
影响因子：
--
通讯作者：
Loggie, BW
中科院分区：
文献类型：
--
作者：
Shen, P;Levine, EA;Loggie, BW
假设：某些临床病理学因素预测腹膜癌转移患者行肿瘤细胞减灭术和腹腔温热化疗后生存率的提高。设计：前瞻性临床试验。设置：大学学术医院的外科肿瘤学服务。患者：1991年12月至1997年11月期间连续治疗的109例腹膜癌转移患者。干预：所有患者均行大体病变切除术，术后2小时灌注丝裂霉素C（20-40 mg）于40.5 ℃的温度下注入腹腔。主要结果测量：独立预测总生存率提高的临床病理因素。1年和3年的总生存率分别为61%和33%。中位随访52个月，中位总生存期为16个月。通过多变量分析，四个因素是提高生存率的重要独立预测因素：非腺癌组织学特征（P= 0.001），阑尾是原发部位（P= 0.003），无肝实质转移（P= 0.01），所有大体疾病的完全切除（R1/0切除）（P
Hypothesis: Certain clinicopathologic factors predict improved survival after cytoreductive surgery and intraperitoneal hyperthermic chemotherapy for peritoneal carcinomatosis.Design: Prospective clinical trial.Setting: Surgical oncology service at a university academic hospital.Patients: A population of 109 consecutive patients with peritoneal carcinomatosis treated between December 1991 and November 1997.Intervention: All patients underwent resection of gross disease followed by 2-hour intraoperative perfusion of mitomycin C (20-40 mg) into the peritoneal cavity at a temperature of 40.5degreesC.Main Outcome Measures: Clinicopathologic factors that independently predicted improved overall survival rates.Results: Overall survival at 1 and 3 years was 61% and 33%, respectively. With median follow-up of 52 months, median overall survival was 16 months. Four factors were significant independent predictors of improved survival by multivariate analysis: nonadenocarcinoma histologic features (P=.001), the appendix as a primary site (P=.003), the absence of hepatic parenchymal metastases (P=.01), and complete resection of all gross disease (R1/0 resection) (P