既往手术评分对肿瘤细胞减灭术加腹腔热灌注化疗治疗腹膜假黏液瘤疗效和安全性影响的研究  

Impacts of prior surgical score on the efficacy and safety of cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy for pseudomyxoma peritonei

作　　者：李鑫宝 于洋 安松林 刘刚 张彦斌 姬忠贺 闫风彩[2] 许洪斌[3] 彭正 李雁 Li Xinbao;Yu Yang;An Songlin;Liu Gang;Zhang Yanbin;Ji Zhonghe;Yan Fengcai;Xu Hongbin;Peng Zheng;Li Yan(Department of Peritoneal Cancer Surgery,Beijing Shijitan Hospital,Capital Medical University,Beijing 100038,China;Department of Pathologyy Beijing Shijitan Hospital,Capital Medical University,Beijing 100038,China;Myxoma Department,Aerospace Central Hospital,Beijing 100049,China;Department of General Surgery,the First Medical Center of Chinese PLA General Hospital,Beijing 100853,China)

机构地区：[1]首都医科大学附属北京世纪坛医院腹膜肿瘤外科,100038 [2]首都医科大学附属北京世纪坛医院病理科,100038 [3]航天中心医院黏液瘤科,北京100049 [4]中国人民解放军总医院第一医学中心普外科,北京100853

出　　处：《中华普通外科杂志》2020年第10期782-787,共6页Chinese Journal of General Surgery

基　　金：北京市医院管理局“登峰”人才培养计划(DFL20180701);首都临床特色应用研究与成果推广项目(Z161100000516077);北京市优秀人才培养资助集体项目(2017400003235J007)。

摘　　要：目的本研究旨在分析既往手术评分(PSS)对肿瘤细胞减灭术(CRS)加腹腔热灌注化疗(HIPEC)治疗腹膜假黏液瘤(PMP)的临床疗效与安全性的影响。方法从PMP临床科研数据库中收集首次行CRS+HIPEC治疗的病例,分析PSS与总生存期、严重不良事件(SAEs)的相关性,评价PSS对疗效和安全性的影响。结果共335例PMP患者首次接受CRS+HIPEC治疗,其中PSS4患者的中位总生存期为58.2个月,PSS-1患者为63.7个月,PSS-2/3患者为55.4个月,各组间差异无统计学意义(χ^2=0.499,P=0.779);按病理类型进行的亚组分析结果显示,组间差异均无统计学意义(均P>0.05)。总体SAEs(χ^2=0.625,P=0.722)、手术相关性SAEs(χ^2=0.267,P=0.901)、非手术相关性SAEs(χ^2=0.677,P=0.715)在不同PSS组间差异均无统计学意义(均P>0.05)。结论在专业化中心,PSS对CRS+HIPEC治疗PMP的疗效和安全性无影响。Objectives To evaluate the impacts of prior surgical scores(PSS)on the clinical efficacy and perioperative safety of cytoreductive surgery(CRS)and hyperthermic intraperitoneal chem otherapy(HIPEC)for pseudomyxoma peritonei(PMP).Methods From the com prehensive PMP database,we collect the cases treated for the first time by CRS+HIPEC,to form this study cohort.The clinicopathological features,PSS,CRS+HIPEC d etails,overall survival(OS),and serious adverse events(SAEs)are systematically analyzed,to study the correlations between PSS and OS or SAEs.Results 335 PMP cases received standardized CRS+HIPEC in this study.The median OS is 58.2 months for PSS-0 patients,63.7 months for PSS-1,and 55.4 months for PSS-2/3,with no statistically significant differences in OS among the different PSS groups(χ^2=0.499,P=0.119).Subgroup analysis by pathologic types also found no statistically significant differences among the different PSS groups.Moreover,no significantly statistical differences are observed in overall SAEs(χ^2=0.625,P=0.722),CRS-related SAEs(χ^2=0.267,P=0.901),and non-CRS-related SAEs(χ^2=0.677,P=0.715),among the different PSS groups.Conclusions PSS does not pose significant impacts on the efficacy and safety of CRS+HIPEC for PMP patients at experienced treatm ent center.

关 键 词：黏液瘤 化学疗法 癌 局部灌注 肿瘤细胞减灭术 

分 类 号：R735.5[医药卫生—肿瘤]