| 安鲁彪,夏 奥,史冠军.扩大姑息减瘤对阑尾源性腹膜假性黏液瘤患者远期生存的作用[J].肿瘤学杂志,2021,27(10):848-853. |
| 扩大姑息减瘤对阑尾源性腹膜假性黏液瘤患者远期生存的作用 |
| Effect of Extended Surgical Resection on Long-term Survival of Appendix-derived Pseudomyxoma Peritonei |
| 投稿时间：2021-04-09 |
| DOI：10.11735/j.issn.1671-170X.2021.10.B010 |
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| 中文关键词: 腹膜假性黏液瘤 姑息性手术 最大限度减瘤 CC-2/CC-3 |
| 英文关键词:pseudomyxoma peritonei palliative surgery maximal tumor debulking surgery CC-2/CC-3 |
| 基金项目:2020年度首都卫生发展科研专项项目（首发2020-4-6083） |
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| 中文摘要: |
| 摘 要：［目的］ 分析扩大姑息减瘤范围对改善腹膜假性黏液瘤(pseudomyxoma peritonei，PMP)患者预后的作用。［方法］ 回顾性分析接受肿瘤细胞减灭手术(cytoreductive surgery，CRS)治疗但仅达到姑息减瘤的阑尾来源PMP患者资料，并应用倾向评分匹配(propensity score-matching，PSM)方法平衡资料中的选择偏倚。［结果］ 共567例未接受达到完全性CRS的患者纳入研究，其中PSM后良好匹配患者153对。匹配后CC-2（残余肿瘤直径为2.5 mm~2.5 cm）患者5年生存率和10年生存率分别为33%和18%，与CC-3（残余肿瘤直径>2.5 cm）患者比较差异无显著性 (5年生存率39%，10年生存率30%；P=0.829)。 以PMP初始诊断日期计算生存期，两者间也无显著性差异(10年生存率 CC-2 vs CC-3：32% vs 44%；P=0.292)。 多因素分析显示，手术时间(OR=2.1，P<0.001)，病理类型(OR=1.57，P=0.004)和是否接受腹腔热灌注化疗（hyperthermic intraperitoneal perfusion chemotherapy，HIPEC）(OR=2.01，P=0.002)是影响预后的独立危险因素。［结论］ 对无法彻底清除病灶的PMP患者，扩大切除手术范围并不能延长患者的远期生存，该部分患者实施HIPEC治疗存在生存获益可能。 |
| 英文摘要: |
| Abstract： ［Objective］ To investigate the effect of extended surgical resection on prognosis of appendix-derived pseudomyxoma peritonei(PMP). ［Methods］ The clinical data of patients with unresectable appendix-derived PMP who received cytoreductive surgery(CRS) but only achieved palliative tumor reduction were retrospectively analyzed. Propensity score matching(PSM) was used to balance the selection bias. ［Results］ A total of 567 patients received incomplete CRS were included in the study， and 153 pairs were well matched after PSM. After matching， there were no significant differences in 5-year and 10-year overall survival(OS) rates between CC-2(residual tumor diameter 2.5 mm~2.5 cm) patients and CC-3(residual tumor diameter > 2.5 cm) patients， respectively(33% vs. 39% and 18% vs 30%； P=0.829). There was also no significant difference in 10-year OS calculated from the date when PMP diagnosed between CC-2 and CC-3 patients(32% vs 44%， P=0.292). Multivariate analysis showed that the year when CRS performed(OR=2.1， P<0.001)， pathological type(OR=1.57， P=0.004) and receiving hyperthermic intraperitoneal chemotherapy(HIPEC)(OR=2.01， P=0.002) were the independent factors influencing the prognosis of patients. ［Conclusion］ Extended debulking surgery does not seem to prolong the overall survival of patients with unresectable tumors. For these patients， HIPEC may be useful in selected cases. |
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