HIPEC application potential in the treatment of extensive carcinomatosis in ovarian cancer (retrospective study)

S. Radostev, L. A. Kolomiets, A. Shelekhov, R. A. Zubkov, D. Morikov, А. A. Medvednikov
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Abstract

Background. The high prevalence of advanced forms of cancer currently requires new treatment approaches. Only modern high-tech surgical procedures can provide means for improving the results of treatment.The aim. To study the results of treatment of patients with ovarian cancer with symptoms of peritoneal carcinomatosis using the HIPEC (Hyperthermic IntraPEritoneal Chemotherapy) method.Materials and methods. The study was conducted in Irkutsk Regional Cancer Center and included 88 patients. They were divided into 2 groups: group 1 – primary cytoreductive surgery (CRS) with the HIPEC method (41 patients); group 2 – primary cytoreductive surgery (47 patients). The most important criterion was the peritoneal cancer index (PCI). If the PCI was ≤ 14, we chose cytoreductive surgery with or without HIPEC.Results. PCI analysis showed differences in its values between the study groups (CRS – 10.17 ± 0.952; CRS + HIPEC – 12.93 ± 0.744; p = 0.002). There was an increase in length of stay in patients who underwent major surgeries in combination with HIPEC (21.8 ± 0.9 days versus 14.5 ± 0.6 days in the CRS group; p = 0.001). The CRS + HIPEC group had a longer duration of surgery (394.88 ± 19.935 min vs. 172.98 ± 11.514 min in the CRS group; p = 0.001). There was an increase in the overall percentage of postoperative complications in the CRS + HIPEC group – up to 26.8 % without statistically significant differences with the CRS group – 8.5 % (p = 0.082). The median time of relapse onset in the CRS + HIPEC group was 26 ± 4.3 months, while in the CRS group it was 18 ± 2.6 months.Conclusion. Using HIPEC method has proven its significance in increasing diseasefree survival.
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HIPEC 在治疗卵巢癌广泛癌变中的应用潜力(回顾性研究)
背景。目前,晚期癌症的高发病率需要新的治疗方法。只有现代高科技外科手术才能为改善治疗效果提供手段。研究采用 HIPEC(腹膜内热化疗)方法治疗伴有腹膜癌症状的卵巢癌患者的效果。研究在伊尔库茨克州癌症中心进行,共纳入 88 名患者。他们被分为两组:第1组--采用HIPEC方法的初级细胞复性手术(CRS)(41名患者);第2组--初级细胞复性手术(47名患者)。最重要的标准是腹膜癌指数(PCI)。如果PCI≤14,我们就选择使用或不使用HIPEC的腹腔镜手术。PCI分析显示,研究组之间的数值存在差异(CRS - 10.17 ± 0.952;CRS + HIPEC - 12.93 ± 0.744;P = 0.002)。接受大手术并同时接受 HIPEC 治疗的患者住院时间延长(CRS 组为 21.8 ± 0.9 天,CRS 组为 14.5 ± 0.6 天;P = 0.001)。CRS+HIPEC组的手术时间更长(394.88±19.935分钟对CRS组的172.98±11.514分钟;P = 0.001)。CRS+HIPEC组的术后并发症总比例增加了,高达26.8%,与CRS组的8.5%相比,差异无统计学意义(p = 0.082)。CRS+HIPEC组的中位复发时间为26±4.3个月,而CRS组为18±2.6个月。结论:HIPEC方法在提高无病生存率方面具有重要意义。
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