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

IF 2.5 3区 医学 Q3 ONCOLOGY World Journal of Surgical Oncology Pub Date : 2025-03-20 DOI:10.1186/s12957-025-03743-z
Xing Lv, Rong-Hua Zhu, Gui-Bao Ji, Jian Li, Wen-Qiang Wang, Jin-Lin Wang, Bin-Yong Liang, Er-Lei Zhang, Zhi-Yong Huang
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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.

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腹腔灌洗洛铂对因肝细胞癌破裂而接受肝切除术的患者存活率的影响。
背景:洛铂术中腹腔灌洗术广泛应用于结、胃癌的治疗。本研究旨在探讨洛铂灌洗治疗破裂型肝癌根治性肝切除术的疗效。方法:将2007年9月~ 2022年3月行肝切除术的肝癌破裂患者分为蒸馏水灌洗组和洛铂灌洗组。采用Kaplan-Meier法生成RFS和OS的生存曲线,采用倾向得分匹配(PSM)进行对数秩检验比较。采用Cox回归分析确定RFS和OS的独立预后因素。结果:本研究共纳入201例患者,蒸馏水灌洗组复发114例(89.1%),洛铂灌洗组复发55例(75.3%),随访期间蒸馏水灌洗组和洛铂灌洗组分别死亡95例(74.2%)和44例(60.3%)。PSM后,蒸馏水灌洗组、洛铂灌洗组1、2、3年RFS分别为38.6%、21.1%、10.5%和57.9%、40.4%、26.3% (P = 0.001)。蒸馏水灌洗组和洛铂灌洗组1、2、3年OS分别为56.1%、40.4%、33.3%和89.5%、63.2%、43.9% (P = 0.001)。多变量Cox回归显示,洛铂灌洗可改善RFS (HR = 0.524, 95% CI: 0.354-0.775;P = 0.001)和OS (HR = 0.524, 95% CI: 0.350-0.783;P = 0.002)。结论:术中洛铂灌洗可改善肝切除术后肝癌破裂患者的RFS和OS。试验注册:TJ-IRB202403002, 2024-04-26,回顾性注册。
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来源期刊
CiteScore
4.70
自引率
15.60%
发文量
362
审稿时长
3 months
期刊介绍: World Journal of Surgical Oncology publishes articles related to surgical oncology and its allied subjects, such as epidemiology, cancer research, biomarkers, prevention, pathology, radiology, cancer treatment, clinical trials, multimodality treatment and molecular biology. Emphasis is placed on original research articles. The journal also publishes significant clinical case reports, as well as balanced and timely reviews on selected topics. Oncology is a multidisciplinary super-speciality of which surgical oncology forms an integral component, especially with solid tumors. Surgical oncologists around the world are involved in research extending from detecting the mechanisms underlying the causation of cancer, to its treatment and prevention. The role of a surgical oncologist extends across the whole continuum of care. With continued developments in diagnosis and treatment, the role of a surgical oncologist is ever-changing. Hence, World Journal of Surgical Oncology aims to keep readers abreast with latest developments that will ultimately influence the work of surgical oncologists.
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