从初级尾癌和结肠直肠癌中发生腹转移的代性细胞减少手术和HIPEC:一项观察性研究
Andrew M Fleming1, Owen M Clark1, Jaewon J Lee2
1Department of Surgery, The University of Tennessee Health Science Center, Memphis, TN 38163, USA.
Cancers
|June 26, 2025
概括
重复细胞减少和高温腹腔内化疗 (CRS/HIPEC) 是复发性尾或结直肠癌患者的安全选择. 在重复CRS/HIPEC后,患者选择对于实现最佳结果和长期存活至关重要.
科学领域:
- 手术瘤学手术瘤学
- 胃肠道瘤学 胃肠道瘤学
- 腹腔周围的恶性瘤
背景情况:
- 在初始细胞减少和高热性腹膜内化疗 (CRS/HIPEC) 后,腹膜复发是常见的挑战.
- 重复CRS/HIPEC为某些患有复发性腹膜疾病的患者提供了一种治疗选择,可能为长期生存带来好处.
研究的目的:
- 评估与尾癌 (pAC) 和结直肠癌 (pCRC) 患者的重复CRS/HIPEC相关的外科治疗结果和生存率.
- 为了确定影响患者重复CRS/HIPEC进行腹复发的患者的结果的因素.
主要方法:
- 一个单一机构数据库的回顾性审查.
- 对外科手术期间的结果进行分析,包括细胞减少 (CCR) 的完整性,手术时间和血液损失.
- 使用Kaplan-Meier和Cox回归分析来评估整体存活时间 (OS).
主要成果:
- 在最初接受CRS/HIPEC治疗的103名患者中,40%的pAC患者和63%的pCRC患者经历了复发.
- 在9名pAC和5名pCRC患者中进行了重复CRS/HIPEC,分别在79%和21%的病例中实现了CRC-0或CRC-1.
- 重复CRS/HIPEC对pAC患者显著改善了OS (p=0.03),但对pCRC患者没有 (p=0.99).
结论:
- 重复CRS/HIPEC是一种安全和可行的程序,用于管理尾癌和结直肠癌单独的腹膜复发.
- 长期存活的潜力存在,特别是在尾癌患者中,这强调了仔细选择患者的重要性.
- 在重复的CRS/HIPEC过程中实现最佳的细胞减少是成功结果的关键决定因素.
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