背景:伴有腹膜转移的胃癌与生存前景降低显著相关。细胞减灭术联合腹腔热化疗(HIPEC)的使用已被证明可以提高这些患者的生存率。尽管取得了这些进步,关于归因于这种治疗方式的生存改善幅度的争论仍然存在.本研究检查了HIPEC后诊断为胃癌和腹膜转移的个体的生存结果,并对细胞学检查结果阳性和阴性的患者进行了比较分析。
目的:比较HIPEC对腹膜转移和细胞学检查阳性或阴性的胃癌患者生存率的影响。
方法:在2013年4月至2020年3月之间,在我们机构接受治疗的84例晚期胃癌患者被分为三组:HIPEC(20例腹膜转移患者),细胞学阳性(23例无腹膜结节但冲洗细胞学阳性),细胞学阴性(41例晚期胃癌,无腹膜结节,和阴性洗涤细胞学)。HIPEC队列接受HIPEC胃切除术,而细胞学阳性和细胞学阴性组仅接受胃切除术.人口统计,病态,并比较各组的生存数据。
结果:HIPEC队列-主要是年轻女性-表现出相对延长的手术持续时间和高失血量。然而,所有三组的并发症发生率一致.HIPEC组的中位生存期为20.00±4.89个月,1年,2年,3年总生存率为73.90%,28.70%,和9.60%,分别。这些数字与细胞学阳性组的生存率(1年时为52.20%,2年时28.50%,和3年时的19.00%)。值得注意的是,47%的患者经历了腹膜复发。
结论:HIPEC可能对胃癌和腹膜转移患者的短期生存有适度改善,反映细胞学阳性患者的结果。然而,腹膜复发率仍然很高。
BACKGROUND: Gastric cancer presenting with peritoneal metastasis is notably associated with diminished survival prospects. The use of cytoreductive surgery in conjunction with hyperthermic intraperitoneal chemotherapy (HIPEC) has been shown to increase survival rates in these patients. Despite these advancements, debates persist regarding the magnitude of survival improvement attributed to this treatment modality. The present investigation examined survival outcomes following HIPEC in individuals diagnosed with gastric cancer and peritoneal metastasis, and it took a comparative analysis of patients exhibiting positive and negative cytological findings.
OBJECTIVE: To compare the impact of HIPEC on survival in gastric cancer patients with peritoneal metastasis and positive or negative cytology.
METHODS: Between April 2013 and March 2020, 84 patients with advanced gastric cancer treated at our institution were categorized into three cohorts: HIPEC (20 patients with peritoneal metastasis), cytology-positive (23 patients without peritoneal nodules but with positive wash cytology), and cytology-negative (41 patients with advanced gastric cancer, no peritoneal nodules, and negative wash cytology). The HIPEC cohort underwent gastrectomy with HIPEC, while the cytology-positive and cytology-negative groups received gastrectomy alone. The demographic, pathological, and survival data of the groups were compared.
RESULTS: The HIPEC cohort-predominantly younger females-exhibited relatively extended surgical durations and high blood loss. Nevertheless, the complication rates were consistent across all three groups. Median survival in the HIPEC group was 20.00 ± 4.89 months, with 1-year, 2-year, and 3-year overall survival rates of 73.90%, 28.70%, and 9.60%, respectively. These figures paralleled the survival rates of the cytology-positive group (52.20% at 1 year, 28.50% at 2 years, and 19.00% at 3 years). Notably, 47% of patients experienced peritoneal recurrence.
CONCLUSIONS: HIPEC may offer a modest improvement in short-term survival for patients with gastric cancer and peritoneal metastasis, mirroring the outcomes in cytology-positive patients. However, peritoneal recurrence remained high.