细胞还原性手术和高热性腹腔内化学疗法用于附癌,腹腔和腹腔膜转移
Ekaterina Baron1, Chih Ching Wu1, Jessica A Wernberg1
1Surgical Oncology, Marshfield Medical Center, 1000 North Oak Avenue, Marshfield, WI, 54449, USA.
概括
细胞还原性手术和高热性腹腔内化疗 (CRS/HIPEC) 显著改善了带有腹腔和腹膜细胞转移的低度尾癌 (AC) 的存活率. 然而,它在高档交流中所带来的好处仍然不确定.
科学领域:
- 手术瘤学手术瘤学
- 胃肠道瘤学 胃肠道瘤学
- 临床研究 临床研究
背景情况:
- 尾癌 (AC) 与腹膜扩散经常经历细胞减小手术和高温腹膜内化疗 (CRS/HIPEC).
- 在IVc AC阶段的患者中,CRS/HIPEC的疗效与同时发生的腹腔内膜和腹膜内膜病变是不确定的.
研究的目的:
- 为了评估CRS/HIPEC的整体生存 (OS) 结果,与单独手术和全身化疗 (SCT) 相比,在尾癌患者中,患有腹膜和腹膜细胞转移.
主要方法:
- 一项多中心回顾性队列研究分析了来自国家癌症数据库 (2004-2019) 的950名患有粘膜性 (MAC) 和非粘膜性 (N-MAC) 及腹膜内外病变的患者.
- 整体存活率 (OS) 在CRS/HIPEC,单独手术和SCT队列中进行了比较.
- 根据瘤组织学和等级进行了子组分析.
主要成果:
- CRS/HIPEC与低级的MAC (未达到vs.50.0vs.26.0个月) 和低级的N-MAC (未达到vs.20.0vs.6.0个月) 的中位寿命明显长于单独手术或SCT.
- 在高等级的AC中,治疗组之间的中位数OS没有显著差异.
- 多变量分析证实CRS/HIPEC在低度MAC和N-MAC中对OS产生了积极影响,但在高度瘤中没有.
结论:
- 对于一些患有低度尾癌 (AC) 的患者,CRS/HIPEC提供了令人鼓舞的生存结果,这些患者呈现了腹膜和膜转移.
- 需要进一步的研究来确定CRS/HIPEC在IVc阶段高等级AC中的有效性.
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