在T4结直肠癌中进行预防性高热性腹腔内化疗:它可以改善瘤预后吗? - 一个倾向得分匹配研究研究
Yuyan Zheng1, Jingjing Zhang1, Chao Chen1
1Zhejiang University School of Medicine Second Affiliated Hospital, Colorectal Surgery, Hangzhou, Zhejiang, China.
概括
预防性高热性腹腔内化疗 (HIPEC) 可能改善T4N0-1M0阶段结直肠癌 (CRC) 患者的生存率. HIPEC并没有增加并发症,并且在T4 CRC的腹腔镜手术中显示出减少腹转移的趋势.
科学领域:
- 在瘤学瘤学.
- 手术瘤学手术瘤学
- 胃肠道瘤学 胃肠道瘤学
背景情况:
- 通过高热性腹腔内化疗 (HIPEC) 进行的细胞还原性手术正在研究患有腹腔转移 (PM) 的结直肠癌 (CRC).
- 在预防CRC向PM的进展方面,HIPEC的有效性仍在争论中.
- 有限PM的精选CRC患者可能受益于HIPEC,可能实现治愈结果.
研究的目的:
- 评估预防性HIPEC对T4期结肠直肠癌患者无病存活率 (DFS) 和腹转移率 (PM) 的影响.
- 评估HIPEC与T4CRC的细胞削减手术结合的安全性和有效性.
- 为了确定HIPEC是否影响了为T4 CRC进行腹腔镜手术的患者的PM风险.
主要方法:
- 进行了一项回顾性倾向分数匹配 (PSM) 队列研究.
- 在2014-2018年期间接受在一个机构接受治疗的cT4N0-2M0患者被审查.
- 主要结局是3年无病生存期 (DFS),同时也分析了3年PM率.
主要成果:
- 预防性HIPEC与改善的DFS相关 (HR 0.43,P=0.037),而N2阶段与更糟糕的DFS相关 (HR 1.97,P=0.025).
- 在腹腔镜手术小组分析中,3年PM率为2.6%与HIPEC相比13.8%没有 (P=0.070).
- 没有发生术后死亡;在HIPEC (2.2%) 和对照组 (0.7%) 之间,静脉漏率相似.
结论:
- 预防性HIPEC可能会改善cT4N0-1M0CRC患者的预后,但对于cT4N2M0CRC患者却没有.
- HIPEC并没有显著提高与手术相关的并发症.
- 对于T4阶段的CRC, laparoscopic手术与HIPEC相结合似乎不会增加PM的风险.
更多相关视频
09:02Percutaneous Hepatic Perfusion PHP with Melphalan as a Treatment for Unresectable Metastases Confined to the Liver
Published on: July 31, 2016
11.9K
06:46Competing-Risk Nomogram for Predicting Cancer-Specific Survival in Multiple Primary Colorectal Cancer Patients after Surgery
Published on: September 27, 2024
290
相关概念视频
02:49Cancer Therapies
7.7K
Cancer therapies are various modes of treatment, such as surgery, radiation therapy, and chemotherapy that are administered to cancer patients.
However, cancer treatments can pose several challenges, as therapies used to kill cancer cells are generally also toxic to normal cells. Moreover, cancer cells mutate rapidly and can develop resistance to chemical agents or radiation therapy. Besides, all types of cancer cells may not respond to the same therapy. Some cancer cells respond to one...
However, cancer treatments can pose several challenges, as therapies used to kill cancer cells are generally also toxic to normal cells. Moreover, cancer cells mutate rapidly and can develop resistance to chemical agents or radiation therapy. Besides, all types of cancer cells may not respond to the same therapy. Some cancer cells respond to one...
7.7K
01:27Tumor Immunotherapy
527
Immunotherapy is a treatment that boosts or manipulates the immune system to fight diseases, including cancer. For instance, by stimulating an immune response through vaccinations against viruses that cause cancers, like hepatitis B virus and human papillomavirus, these diseases can be prevented. Nonetheless, some cancer cells can avoid the immune system due to their rapid mutation and division. The immune response to many cancers involves three phases: elimination, equilibrium, and escape.
527