背景:肥胖是全球范围内越来越多的公共卫生问题。关于肥胖对腹膜癌病治疗后结果的影响的文献很少。我们的目的是根据体重指数比较细胞减灭术和腹腔热化疗对罕见腹膜恶性肿瘤的术后和肿瘤学结果。
方法:所有患者均采用细胞减灭术和腹腔热灌注化疗治疗罕见的腹膜恶性肿瘤(主要包括腹膜假性黏液瘤和腹膜间皮瘤)。在1995年至2020年期间,回顾性纳入了法国国家罕见腹膜肿瘤登记处。
结果:1450例患者被回顾性纳入(63.5%为女性,平均年龄54±13岁)。根据体重指数将患者分为两组:非肥胖(n=1248,86%)和肥胖(n=202,14%)。与肥胖患者相比,非肥胖患者的总发病率显着降低(n=532/1248,43%vsn=106/202,53%,p=0.009)。与肥胖患者相比,非肥胖患者的内科和外科发病率显着降低(423/1258,34%vsn=86/202,43%,p=0.02和n=321/1248,26%vsn=67/202,33%,分别为p=0.003)。一个-,非肥胖和肥胖患者的5年和10年总生存率相似(95%,82%和70%vs94%,76%和63%;p=0.1)。一个-,非肥胖和肥胖患者的5年和10年无病生存率相似(84%,67%和61%vs79%,62%和56%,p=0.1)。
结论:肥胖患者在进行细胞减灭术和腹腔热化疗治疗罕见的腹膜恶性肿瘤后必须小心管理。一些围手术期的预防性治疗可以特别实施,以减少血栓栓塞事件。代谢和伤口并发症。
BACKGROUND: Obesity is a public health concern with an increasing occurrence worldwide. Literature regarding impact of obesity on results after management of peritoneal carcinomatosis is poor. Our aim was to compare postoperative and oncological outcomes after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for rare peritoneal malignancies according to the body mass index.
METHODS: All the patients managed by cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for rare peritoneal malignancies (including mainly pseudomyxoma peritonei and peritoneal mesothelioma), between 1995 and 2020, were retrospectively included from the French national registry of rare peritoneal tumors.
RESULTS: 1450 patients were retrospectively included (63.5 % female, mean age 54 ± 13 years). Patients were divided into two groups according to their body mass index: non-obese (n = 1248, 86 %) and obese (n = 202, 14 %). Overall morbidity was significantly lower in non-obese patients in comparison with obese patients (n = 532/1248, 43 % vs n = 106/202, 53 %, p = 0.009). Medical and surgical morbidities were significantly lower in non-obese patients in comparison with obese patients (423/1258, 34 % vs n = 86/202, 43 %, p = 0.02 and n = 321/1248, 26 % vs n = 67/202, 33 %, p = 0.003, respectively). One-, 5- and 10-year overall survivals were similar between non-obese and obese patients (95 %, 82 % and 70 % vs 94 %, 76 % and 63 %; p = 0.1). One-, 5- and 10-year disease free survivals were similar between non-obese and obese patients (84 %, 67 % and 61 % vs 79 %, 62 % and 56 %, p = 0.1).
CONCLUSIONS: Obese patients have to be carefully managed after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for rare peritoneal malignancies. Some perioperative prophylactic treatments could be specifically implemented to reduce thromboembolic events, metabolic and wound complications.