Cytoreductive surgery combined with hyperthermic intraperitoneal chemoperfusion for the treatment of gastric cancer: A single-centre retrospective study.
Cytoreductive surgery combined with hyperthermic intraperitoneal chemoperfusion for the treatment of gastric cancer: A single-centre retrospective study.
复制标题
细胞减灭术联合腹腔热灌注化疗治疗胃癌：单中心回顾性研究。
DOI：
10.1080/02656736.2016.1190987
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发表时间：
2016
期刊：
影响因子：
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通讯作者：
Cui Shuzhong
中科院分区：
文献类型：
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作者：
Tu Yinuo;Tian Yunhong;Fang Zhiyuan;Ruan Qiang;Tang Hongsheng;Zhang Xiangliang;Wu Yinbing;Ding Yan;Cui Shuzhong
目的：细胞减灭术（CRS）联合腹腔温热化疗灌注（HIPEC）是最有可能延长胃肠癌腹膜转移患者生存期的治疗方案。迄今为止，很少有出版物关注单独胃癌患者的治疗。一些争议仍未解决，包括CRS-HIPEC联合方案的安全性和有效性，特别是在HIPEC用作CRS后辅助治疗的情况下。因此，在本研究中，我们旨在评估CRS联合HIPEC治疗胃癌患者的安全性和有效性。方法：回顾性分析2009年1月至2014年12月期间接受CRS-HIPEC联合方案治疗的231例患者的数据，中位年龄为55.1岁。结果：中位生存期为37.0个月，1、2、3年生存率分别为83.4%、68.5%、38.7%。联合治疗后，CCR-0和CCR-1组血清CEA和CA 199水平均显著下降，而CC ≥2组血清CEA和CA 199水平无显著变化。术后并发症和死亡率分别为6.9%和0.9%。多变量分析显示，低TNM肿瘤分期，腹水条件和CCR评分作为独立的预测因子，为更好的survival.Conclusion：在可接受的发病率和死亡率，我们建议，CRS结合HIPEC胃癌患者提出了一种有效和安全的治疗方式，特别是在最佳的cytoreduction是在HIPEC程序之前实现的情况下。
Aim:Cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemoperfusion (HIPEC) is the treatment regime most likely to achieve prolonged survival in patients with peritoneal carcinomatosis from gastroenteric cancer. To date, few publications have focused on the treatment of patients with gastric cancer alone. Several controversies remain unsolved, including the safety and effectiveness of the CRS–HIPEC combination regime, particularly in cases where HIPEC is used as adjuvant treatment after CRS. Therefore, in the current study, we aimed to evaluate the safety and effectiveness of CRS combined with HIPEC in patients with gastric cancer.Method:Data from 231 patients with a median age of 55.1 years treated with the CRS–HIPEC combination regime between January 2009 and December 2014 were retrospectively reviewed. All patients underwent the combination therapy (mean of 2.4 cycles per patient, range, 1 to 4 cycles).Results:Median overall survival was 37.0 months, with 1-, 2- and 3-year survival rates recorded as 83.4%, 68.5%, and 38.7%, respectively. The serum levels of carcinoembryonic antigen (CEA) and carbohydrate antigen 199 (CA199) were significantly decreased after combination therapy in the completeness of cytoreduction (CCR)-0 and CCR-1 groups, while no significant changes observed in marker levels were observed in the CC ≥2 group. The post-operative morbidity and mortality rates were 6.9% and 0.9%, respectively. Multivariate analysis revealed low TNM tumour stage, ascites condition and CCR score as independent predictors for better survival.Conclusion:In view of the acceptable morbidity and mortality rates we propose that CRS combined with HIPEC presents an effective and safe treatment modality for patients with gastric cancer, especially in cases where optimal cytoreduction is achieved before the HIPEC procedure.