预防性腹腔热灌注化疗对局部进展期胃癌根治术后病人预后改善的有效性研究  

Efficacy with prognostic value of postoperative prophylactic hyperthermic intraperitoneal chemotherapy for lo⁃cally advanced gastric cancer

作　　者：孙祺 黄文博 何炳良 刘畅[1] 徐宇航 赵伟[1] SUN Qi;HUANG Wenbo;HE Bingliang;LIU Chang;XU Yuhang;ZHAO Wei(Department of General Surgery,the First Affiliated Hospital of Xi'an Jiaotong University,Shaanxi Xi'an 710061,China)

机构地区：[1]西安交通大学第一附属医院普通外科,陕西西安710061

出　　处：《外科理论与实践》2023年第4期366-370,共5页Journal of Surgery Concepts & Practice

基　　金：国家自然科学基金(81702362);陕西省重点研发计划(2019SF⁃057)。

摘　　要：目的:探讨术后预防性腹腔热灌注化疗(hyperthermic intraperitoneal chemotherapy,HIPEC)对临床分期为cT3⁃4NxM0的局部进展期胃癌病人的临床治疗价值。方法:回顾性收集分析2016年1月至2021年12月我院普通外科收治的60例接受D2根治术局部进展期(cT3⁃4NxM0)胃癌病人的临床资料。将接受预防性HIPEC的病人纳入HIPEC组(n=30),未接受预防性HIPEC的病人纳入对照组(n=30),两组病人均进行术后常规辅助系统化疗。通过随访比较两组病人的中位生存时间和总生存率,分析影响总生存率的危险因素。结果:HIPEC组的中位生存时间51.0个月(95%CI:40.7~61.3),高于对照组的30.0个月(95%CI:16.3~43.7)。HIPEC组的3年和5年总生存率(66.7%、53.3%)均高于对照组(56.7%、43.3%)(P=0.019)。预防性HIPEC是影响局部进展期胃癌术后病人预后的保护因素(P=0.021)。结论:对于cT3⁃4NxM0局部进展期胃癌病人,预防性HIPEC能够延长病人根治术后的中位生存时间,提高总生存率。Objective To explore the efficacy with prognostic value of postoperative prophylactic hyperthermic intra⁃peritoneal chemotherapy(HIPEC)for locally advanced gastric cancer with clinical stage cT3⁃4NxM0.Methods A retrospec⁃tive collection and analysis of clinical data was conducted from 60 patients with locally advanced gastric cancer(cT3⁃4NxM0)who underwent D2 radical surgery between January 2016 and December 2021 at our department.Patients who underwent prophylactic HIPEC were classified into the HIPEC group(n=30),while patients who did not undergo prophylactic HIPEC were clssified into the control group(n=30).Both groups of patients routinely were treated with postoperative adjuvant sys⁃temic chemotherapy.The median survival time,and overall survival rate of the two groups were compared through follow⁃up,and the risk factors affecting the overall survival rate were analyzed.Results The median survival time of the HIPEC group was 51.0 months(95%CI:40.7-61.3),which was higher than that of the control group with 30.0 months(95%CI:16.3-43.7).The 3⁃year and 5⁃year overall survival rates of the HIPEC group(66.7%,53.3%)were higher than those of the control group(56.7%,43.3%)(P=0.019).Prophylactic HIPEC was the protective factor affecting the overall survival rate of postoperative patients with locally advanced gastric cancer(P=0.021).Conclusions For patients with locally advanced cT3⁃4NxM0 gastric cancer,prophylactic HIPEC plays an important role in prolonging the median survival time,hence impro⁃ving the overall survival rate of patients.

关 键 词：胃癌 腹腔热灌注化疗 局部进展期 腹膜转移 生存分析 

分 类 号：R735.2[医药卫生—肿瘤]