Impact of intraperitoneal lavage with lobaplatin on survival in patients undergoing hepatectomy for ruptured hepatocellular carcinoma.

Abstract

Background: Intraoperative intraperitoneal lavage with lobaplatin is widely used in the treatment of colorectal and gastric cancers. This study aimed to explore the efficacy of lobaplatin lavage in patients with ruptured hepatocellular carcinoma (HCC) administered radical hepatectomy.

Methods: Ruptured HCC patients who underwent hepatectomy between September 2007 and March 2022 were divided into the distilled water lavage and lobaplatin lavage groups. Survival curves for RFS and OS were generated by the Kaplan-Meier method and compared by the log-rank test using Propensity Score Matching (PSM). Cox regression analysis was conducted to identify independent prognostic factors of RFS and OS.

Results: This study included 201 patients, with 114 cases (89.1%) in the distilled water lavage group and 55 cases (75.3%) in the lobaplatin lavage group experiencing recurrence, and 95 (74.2%) and 44 (60.3%) patients died in the distilled water lavage and lobaplatin lavage groups, respectively during the follow-up period. After PSM, 1-, 2-, 3-year RFS rates were 38.6%, 21.1%, 10.5% and 57.9%, 40.4%, 26.3% in the distilled water lavage and lobaplatin lavage groups, respectively (P = 0.001). 1-, 2-, 3-year OS rates were 56.1%, 40.4%, 33.3% and 89.5%, 63.2%, 43.9% in the distilled water lavage and lobaplatin lavage groups, respectively (P = 0.001). Multivariable Cox regression indicated that lobaplatin lavage may improve RFS (HR = 0.524, 95% CI: 0.354-0.775;P = 0.001) and OS (HR = 0.524, 95% CI: 0.350-0.783;P = 0.002).

Conclusions: Intraoperative lobaplatin lavage improves RFS and OS in patients with ruptured HCC after hepatectomy.

Trial registration: TJ-IRB202403002, 2024-04-26, retrospectively registered.