在急性穿孔尾炎后诊断的尾腺癌:HIPEC的潜在贡献
Elsa Leiritz1, Jérémy Rezai2, Mathilde Wagner3
1Department of Digestive, Hepatobiliary Surgery and Liver Transplantation, Pitié-Salpêtrière Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France.
概括
带有穿孔的尾腺癌可能出现腹膜转移. 细胞还原性手术 (CRS) 和高热性腹腔内化疗 (HIPEC) 是一种拟议的治疗方法,在无病生存方面显示出有希望的结果.
科学领域:
- 在瘤学瘤学.
- 手术瘤学手术瘤学
- 胃肠道手术 胃肠道手术
背景情况:
- 尾腺癌可以穿孔,导致急性尾综合征 (AAS).
- 腹膜转移是穿孔尾腺癌的常见并发症.
- 目前的治疗指南缺乏对穿孔尾腺癌与腹膜转移的建议.
研究的目的:
- 为了评估细胞还原性手术 (CRS) 和高热性腹内化疗 (HIPEC) 对附腺癌与腹转移的疗效.
- 评估接受CRS和HIPEC的患者的治疗结果,包括生存率和复发率.
- 在尾腺癌的紧急尾切除术中确定腹膜转移的发生率.
主要方法:
- 对21名连续被诊断患有尾腺癌的患者进行了回顾性审查.
- 评估治疗算法,手术内决策,生存率和复发率.
- 患者接受了紧急手术,随后如果有指示,接受了CRS和HIPEC.
主要成果:
- 四名患有同步腹转移的患者接受了CRS和HIPEC.
- 在没有初始转移的17名患者中,8人接受了预防性CRS和HIPEC.
- 预防性CRS和HIPEC组显示12.5%的复发率和100%的整体存活率在5年.
- 在36%接受CRS和HIPEC的患者中,发生了III-IV级外科并发症.
结论:
- 由于穿孔尾腺癌而接受紧急尾切除术的患者中,大约有一半可能患有腹膜转移.
- 在未确定的腹膜转移病例中,CRS后的预防性HIPEC似乎与有利的5年无病生存率有关.
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