【摘 要】
：
目的 胃癌腹膜癌预后极差,尚无标准治疗.本研究旨在通过单中心回顾性分析,研究肿瘤细胞减灭术加腹腔热灌注化疗治疗胃癌腹膜癌的有效性,筛选预后预测指标,构建预后预测模型.方法 收集2005 年～2017 年之间于本单位接受肿瘤细胞减灭术加腹腔热灌注化疗综合治疗的115 例胃癌腹膜癌患者临床资料与预后信息,以主要临床病理特征及手术相关指标划分亚组进行统计分析,主要研究终点是总生存期.结果 115 例胃癌
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目的 胃癌腹膜癌预后极差,尚无标准治疗.本研究旨在通过单中心回顾性分析,研究肿瘤细胞减灭术加腹腔热灌注化疗治疗胃癌腹膜癌的有效性,筛选预后预测指标,构建预后预测模型.方法 收集2005 年～2017 年之间于本单位接受肿瘤细胞减灭术加腹腔热灌注化疗综合治疗的115 例胃癌腹膜癌患者临床资料与预后信息,以主要临床病理特征及手术相关指标划分亚组进行统计分析,主要研究终点是总生存期.结果 115 例胃癌腹膜癌患者接受肿瘤细胞减灭术加腹腔热灌注化疗121 次,中位总生存期为13.1月,1 年、2 年、3 年、5 年生存率分别为：56.5％、25.3％、12.6％、8.1％,4 例患者生存时间超过5年.单因素分析显示,性别(P = 0.004)、术前肿瘤标志物(P ＜ 0.001)、腹膜癌时相(P ＜0.001)、腹腔热灌注化疗温度(P = 0.020)与时长(P = 0.023),肿瘤细胞减灭程度(P ＜0.001)、严重不良事件(P = 0.085)、辅助化疗类型(P ＜ 0.001)和腹膜癌指数(P ＜ 0.001)亚组总生存期有显著性差异.多因素分析显示,肿瘤细胞减灭程度、腹腔热灌注化疗温度和辅助化疗类型为预测总生存的独立预后因子.结论 肿瘤细胞减灭术加腹腔热灌注化疗综合治疗策略可显著延长胃癌腹膜癌患者总生存期,部分患者可实现临床治愈.完全肿瘤细胞减灭术、43 ℃ 腹腔热灌注化疗和术后系统或系统联合腹腔化疗是胃癌腹膜癌获得最大生存受益的关键.
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