腹腔热灌注化疗预防性应用于老年局部进展期胃癌患者的安全性评价  

Safety evaluation of prophylactic hyperthermic intraperitoneal chemotherapy in elderly patients with locally advanced gastric cancer

作　　者：马福海 安琦[1] 曹祥龙[1] 吴国举[1] 肖刚[1] 余涛[1] Ma Fuhai;An Qi;Cao Xianglong;Wu Guoju;Xiao Gang;Yu Tao(Department of General Surgery,Department of Gastrointestinal Surgery,Beijing Hospital,National Center of Gerontology,Institute of Geriatric Medicine,Chinese Academy of Medical Sciences,100730,Beijing,China)

机构地区：[1]北京医院普通外科、胃肠外科国家老年医学中心、中国医学科学院老年医学研究院,北京100730

出　　处：《中华老年医学杂志》2023年第7期836-841,共6页Chinese Journal of Geriatrics

基　　金：中央高水平医院临床科研业务费(BJ-2022-170)。

摘　　要：目的评价预防性腹腔热灌注化疗(HIPEC)治疗老年胃癌患者的短期疗效。方法纳入2017年1月至2022年9月于北京医院行根治性手术联合术后HIPEC治疗的局部进展期胃癌患者。以65岁为节点,将患者分为年轻组(45例)和老年组(32例)。通过对比两组患者的临床病理资料、术后恢复情况、并发症发生情况及实验室检查,评价HIPEC预防性应用于老年胃癌患者的安全性。结果与年轻组相比,老年组患者具有更高的慢性疾病合并率和美国麻醉医师协会(ASA)分级。老年组患者接受HIPEC治疗的次数较年轻组患者减少,年轻组患者接受1次、2次及3次HIPEC治疗的比例分别为8.9%、57.8%及33.3%,老年组分别为28.1%、59.4%、12.5%(P=0.030)。两组患者肿瘤分期、类型、部位、分化程度等病理特征差异无统计学意义。两组患者接受腹腔镜手术比例、手术切除范围、手术联合脏器切除、手术时间、术中出血量差异无统计学意义。年轻组和老年组患者术后并发症发生率分别为20.0%和21.9%,差异无统计学意义(P=0.100)。两组患者术后住院时间分别为(14.0±8.3)d和(15.5±9.9)d(P=0.480)。结论与年轻胃癌患者比较,老年胃癌患者根治性手术联合HIPEC治疗不增加术后并发症发生率和术后恢复时间。从术后恢复情况及实验室检查证实HIPEC应用于老年胃癌患者是安全可行的。Objective To analyze the short-term effects of prophylactic intraperitoneal hyperthermic chemotherapy(HIPEC)on elderly patients diagnosed with gastric cancer.MethodsThe study enrolled patients with gastric cancer who underwent curative gastrectomy combined with postoperative HIPEC at Beijing Hospital between January 2017 and September 2022.The patients were divided into two groups based on age:young patients(age<65 years,n=45)and elderly patients(age≥65 years,n=32).The study evaluated the safety of HIPEC prophylactic application in elderly patients with gastric cancer by comparing their clinicopathological data,postoperative recovery,complications,and laboratory tests with those of another group of patients.ResultsThe study found that the elderly patients had a higher rate of comorbidities and higher ASA scores compared to the younger patients.Additionally,the elderly patients received HIPEC treatment less frequently than the younger patients(P=0.030).The proportion of young patients receiving one,two,and three times of HIPEC treatment was 8.9%,57.8%,and 33.3%,respectively,while the proportion of elderly patients receiving the same was 28.1%,59.4%,and 12.5%,respectively.The study found no significant differences in pathological characteristics between the two groups,including tumor stage,type,location,and differentiation degree.Additionally,there was no difference in the proportion of laparoscopic gastrectomy,type of resection,combined resection,duration of the operation,and intraoperative blood loss between elderly and young patients.The rate of complications between the two groups was also not significantly different(20.0%vs.21.9%;P=0.100).The mean duration of hospitalization after radical gastrectomy was 14.0 days in the young group and 15.5 days in the elderly group,respectively(P=0.480).ConclusionsElderly patients with gastric cancer treated with radical gastrectomy combined with HIPEC did not experience increased postoperative complications or hospital stay compared to young patients,suggesting that proph

关 键 词：胃肿瘤 预防性腹腔热灌注化疗 治疗结果 

分 类 号：R735.2[医药卫生—肿瘤]