细胞减灭术联合腹腔热灌注化疗治疗腹膜假性黏液瘤患者预后分析  

Prognostic analysis of patients with pseudomyxoma peritonei after cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy

作　　者：潘艳玲[1] 梁贤文[2] 王胜忠[2] 李义杰 Pan Yanling;Liang Xianwen;Wang Shengzhong;Li Yijie(Department of Tumor Radiotherapy,Affiliated Haikou Hospital of Xiangya Medical College of Central South University,Haikou 570208,China;Department of Gastroenterology,Affiliated Haikou Hospital of Xiangya Medical College of Central South University,Haikou 570208,China)

机构地区：[1]中南大学湘雅医学院附属海口医院肿瘤放疗科,570208 [2]中南大学湘雅医学院附属海口医院胃肠外科,570208

出　　处：《肿瘤研究与临床》2020年第5期357-360,共4页Cancer Research and Clinic

摘　　要：目的评估细胞减灭术(CRS)联合腹腔热灌注化疗(HIPEC)治疗腹膜假性黏液瘤(PMP)患者的临床预后。方法回顾性分析2012年1月至2018年12月中南大学湘雅医学院附属海口医院收治的42例PMP患者的临床资料。所有患者均行开腹CRS联合HIPEC,对患者的手术情况及预后情况进行分析。结果42例PMP患者中腹膜腺黏液蛋白沉积病(DPAM)占61.9%(26/42),腹膜黏液蛋白癌病(PMCA)占28.6%(12/42),混合型占9.5%(4/42)。CRS联合HIPEC后主要手术并发症(Ⅲ~Ⅳ级)发生率为21.4%(9/42)。logistic回归分析显示,既往手术评分(OR=35.765,95%CI 2.746~43.986,P=0.001)及CRS完成度评分(OR=23.865,95%CI 1.345~347.876,P=0.028)是影响PMP患者术后主要并发症的独立因素。42例PMP患者总生存时间为(64.8±4.1)个月,无瘤生存时间为(54.0±4.9)个月;3年和5年总生存率分别为80.8%和65.9%,3年和5年无瘤生存率分别为59.5%和54.6%;不同病理亚型患者的总生存时间差异有统计学意义(P=0.022)。结论CRS联合HIPEC治疗PMP安全有效,多数患者预后较好。Objective To evaluate the clinical prognosis of patients with pseudomyxoma peritonei(PMP)after cytoreductive surgery(CRS)combined with hyperthermic intraperitoneal chemotherapy(HIPEC).Methods The clinical data of 42 patients with PMP after CRS combined with HIPEC in the Affiliated Haikou Hospital of Xiangya Medical College of Central South University from January 2012 to December 2018 was retrospectively analyzed.All patients underwent open surgery CRS combined with HIPEC,the operation condition and prognosis of patients were analyzed.Results In 42 patients with PMP,the disenminated peritoneal adenomucinosis(DPAM)accounted for 61.9%(26/42),the peritoneal mucinous carcinomatosis(PMCA)accounted for 28.6%(12/42),and the borderline accounted for 9.5%(4/42).The incidence rate of major operative complications(gradeⅢ-Ⅳ)after CRS combined with HIPEC was 21.4%(9/42).The logistic regression analysis showed that the previous surgery score(OR=35.765,95%CI 2.746-43.986,P=0.001)and completeness of CRS score(OR=23.865,95%CI 1.345-347.876,P=0.028)were independent factors influencing major postoperative complications in PMP patients.The overall survival time of 42 patients with PMP was(64.8±4.1)months,and the disease-free survival time was(54.0±4.9)months;the 3-year and 5-year overall survival rates were 80.8%and 65.9%,and the 3-year and 5-year disease-free survival rates were 59.5%and 54.6%,respectively.The difference in overall survival time of patients with different pathological subtypes was statistically significant(P=0.022).Conclusion CRS combined with HIPEC is safe and effective for treatment of patients with PMP,and most of the patients have a good prognosis.

关 键 词：腹膜肿瘤 腹膜假性黏液瘤 细胞减灭术 腹腔热灌注化疗 预后 

分 类 号：R735[医药卫生—肿瘤]