肿瘤减灭术联合腹腔热灌注化疗治疗结直肠癌腹膜转移的回顾性研究  

A retrospective study of tumor cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy in the treatment of peritoneal metastases in colorectal cancer

作　　者：邱继刚 朱巍莹 沈达明 赵洪[2] 王艳富 朱君秋[2] 吉永烁[2] Qiu Jigang;Zhu Weiying;Shen Daming;Zhao Hong;Wang Yanfu;Zhu Junqiu;Ji Yongshuo(Department of General Surgery,Huadong Hospital of Fudan University,Shanghai 200040,China;Department of Tumor Hyperthermia,Huadong Hospital of Fudan University,Shanghai 200040,China)

机构地区：[1]复旦大学附属华东医院普外科,上海200040 [2]复旦大学附属华东医院肿瘤热疗中心,上海200040

出　　处：《中华转移性肿瘤杂志》2021年第3期205-210,共6页Chinese Journal of Metastatic Cancer

摘　　要：目的观察肿瘤减灭术(CRS)联合腹腔热灌注化疗(HIPEC)治疗结直肠癌腹膜转移的效果。方法收集2017—2019年于复旦大学附属华东医院普外科收治的61例结直肠癌腹膜转移患者的临床资料进行回顾性分析。将其中34例CRS联合HIPEC设为观察组,27例仅行CRS者设为对照组。比较两组患者手术相关资料(联合脏器切除、吻合口数量、PCI指数、CC评级、出血量),术后近期并发症情况及远期复发情况;术前,术后2周、1个月和3个月CEA、CA199水平。采用Kaplan-Meier法生存分析。结果两组患者手术相关资料、术后近期并发症、术前及术后2周CEA、CA199水平均相近(均P>0.05)。观察组术后复发率,术后1个月和3个月CEA、CA199水平均低于对照组(均P<0.05)。全组患者术后中位生存期14.2个月,观察组优于对照组(16.8个月∶13.0个月,P<0.05)。结论CRS联合HIPEC治疗结直肠癌腹膜转移安全有效,HIPEC有助于降低肿瘤患者术后肿瘤负荷。Objective To observe the effect of cytoreductive surgery(CRS)combined with hyperthermicintraperitoneal chemotherapy(HIPEC)in the treatment of peritoneal metastasis of colorectal cancer.Methods Clinical data of 61 patients with peritoneal metastasis of colorectal cancer admitted to the department of general surgery in Huadong Hospital affiliated to Fudan University from April 1,2017 to March 31,2019 were collected for retrospective analysis.Among them,34 cases of CRS combined with HIPEC were set as the observation group,and 27 cases of CRS were set as the control group.The two groups were compared in terms of surgical status(combined visceral resection,number of anastomosis,PCI index,CC score,blood loss,etc.),postoperative short-term complications and long-term recurrence,and the levels of CEA and CA199 before,2 weeks after,1 month and 3 months after surgery.Kaplan-Meier method was used survival analysis.Results There was no statistically significant difference between the two groups in the operative data(PCI,CC score,combined resection of organs,number of anastomotic sites and amount of blood loss),short term postoperative complications,preoperative and 2-week postoperative CEA and CA199 levels(P>0.05).The postoperative recurrence rate,CEA and CA199 levels of the observation group at 1 and 3 months after surgery were all lower than those of the control group,with statistically significant differences(P<0.05).The median overall survival time(MST)of 61 patients was 14.2 months,and the observation group was better than MST the control group(16.8 months vs.13.0months,P<0.05).Conclusion Tumor CRS combined with HIPEC is safe and effective in the treatment of peritoneal metastasis of colorectal cancer.

关 键 词：腹膜转移 结直肠癌/外科学 肿瘤减灭术 腹膜转移 结直肠癌/化学疗法 腹腔热灌注化疗 

分 类 号：R73[医药卫生—肿瘤]