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在细胞还原性手术和大肠直肠癌的高热内皮质化疗后的术后白血病 - - 原因和对基于人口的研究结果的影响

Mattias Lepsenyi¹, Valentinus Valdimarsson², Nader Algethami²

¹Department of Clinical Sciences Malmö, Section of Surgery, Lund University, Skåne University Hospital, Inga Marie Nilssons gata 47, Malmö, 20502, Sweden. mattias.lepsenyi@med.lu.se.

World journal of surgical oncology

|April 29, 2025

概括

在细胞还原性手术和高温腹腔内化疗 (HIPEC) 后的术后白血病并没有显著影响结直肠癌复发或存活率. 然而,新辅助化疗和高腹癌指数 (PCI) 分数与更糟糕的结果有关.

科学领域:

在瘤学瘤学.
手术瘤学手术瘤学
癌症研究癌症研究

背景情况:

白细胞可能促进结直肠癌中的瘤生长.
以前的研究表明,手术后的中性质减退可能会改善存活率.
细胞还原性手术 (CRS) 和高热性腹腔内化疗 (HIPEC) 用于晚期癌症.

研究的目的:

研究术后白血病对CRS和HIPEC后复发,存活率和并发症的影响.
在接受CRS和HIPEC的结直肠癌患者中确定影响复发和死亡的因素.

主要方法:

从瑞典登记处 (2003-2021) 分析了584例经过CRS和HIPEC的结直肠腺癌病例.
主要结果:整体复发率. 二次结果:整体存活率,无复发性存活率和外科手术后并发症.
排除不完整的程序,不充分的细胞减少或缺少白细胞数据的病例.

主要成果:

手术后白血病发生在9.2%的患者中;严重的白血病发生在5.5%的患者中.
在患有白血病或没有白血病的患者之间,没有观察到复发率或存活率的显著差异.
新辅助化疗,更高的PCI得分和更高的PN阶段与复发率的增加有关.
新辅助化疗,严重的术后并发症和高PCI得分与3年死亡率有关.
组合牛利/伊利诺特干治疗与发展白血病相关.
更长的手术时间和严重的白血病与术后并发症有关.

结论:

手术后白血病似乎没有显著影响长期复发或CRS和HIPEC之后的存活率对于结直肠癌.
新辅助化疗和高PCI得分是复发和死亡率的重要预测因素.
进一步的研究可能会澄清白血病和其管理在这种情况下的作用.

关键词:

细胞还原性手术是指细胞还原性手术.超热周围手术化疗超热周围手术化疗术后并发症术后并发症手术后的白血病.

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