Clinical Effect of Combination of Cytoreductive Surgery and Hyperthermic Intraperi-toneal Chemotherapy for Treating Hepatocellular Carcinoma with Peritoneal Metastasis_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 ZHANGYun , LIZhong , HEJun-ting ,  GUOChun-liang

Department of Hepatobiliary Surgery, Affiliated Hospital of Armed Police Logistics Institute, Tianjin 300162, China;

Corresponding?author：

GUOChun-liang, Email: guochunl@126.com

Keywords：

Cytoreductive surgery; Hyperthermic intraperitoneal chemotherapy; Hepatocellular carcinoma; Peritoneal metastasis; Prognosis

DOI：

10.7507/1007-9424.20150086

Video：

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Objective To investigate the curative effects of cytoreductive surgery (CRS) combined with hyper-thermic intraperitoneal chemotherapy (HIPEC) for treating the hepatocellular carcinoma with peritoneal metastasis. Methods The clinical data of 80 cases of hepatocellular carcinoma with peritoneal metastasis who were treated in our hospital from January 2004 to January 2012 were collected, and were classified into observation group (n=40) and control group (n=40) according to the treatment. Case of observation group received CRS+HIPEC, and cases of control group received CRS+conventional intraperitoneal injection of chemotherapy. Then the comparison of clinical effect and prog-nosis was performed. Results In observation group, the results of completeness of cytoreduction (CC) grade was:31 cases in grade 0, 6 cases in grade 1, and 3 cases in grade 2. In control group, the results of CC grade was:32 cases in grade 0, 6 cases in grade 1, and 2 cases in grade 3. There was no significant difference between 2 groups in the CC grade (P=0.213). In addition, there were no significant differences between observation group and control group in operation time (6.8 hours vs. 6.5 hours), hospital stay (17.3 days vs.18.7 days), and incidence of adverse reactions[70.0% (28/40) vs. 60.0% (24/40)], P>0.05. All of the cases of observation group and control group were followed up for 10-61 months (average of 42.5 months) and 6-49 months (average of 30.2 months) respectively. During the follow up period, in observation group, there were 18 cases died, 12 cases suffered from recurrence, 5 cases suffered from metastasis, and the rest of 5 cases survived; in the control group, there were 26 cases died, 9 cases suffered from recurrence, and 5 cases suffered from metastasis. However, the survival situation was better in observation group than that of control group (P<0.01). Conclusion Combining CRS and HIPEC for treating hepatocellular carcinoma with peritoneal metastasis was safe and effective, which would be widely applied.

Citation： ZHANGYun, LIZhong, HEJun-ting, GUOChun-liang. Clinical Effect of Combination of Cytoreductive Surgery and Hyperthermic Intraperi-toneal Chemotherapy for Treating Hepatocellular Carcinoma with Peritoneal Metastasis. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2015, 22(3): 322-325. doi: 10.7507/1007-9424.20150086 Copy

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2.	Mazzaferro V, Bhoori S, Sposito C, et al. Milan criteria in liver transplantation for hepatocellular carcinoma:an evidence-based analysis of 15 years of experience. Liver Transpl, 2011, 17 Suppl 2:S44-S57.
3.	Chua TC, Morris DL. Exploring the role of resection of extrahepatic metastases from hepatocellular carcinoma. Surg Oncol, 2012, 21(2):95-101.
4.	崔書中, 王佳泓, 張相良. 腫瘤細胞減滅術聯合腹腔熱灌注化療治療結直腸癌腹膜轉移癌. 中國腫瘤臨床, 2012, 39(22):1691-1695.
5.	唐利, 梅列軍, 李雁, 等. 細胞減滅術加腹腔熱灌注化療治療胃癌腹膜轉移癌. 中華實驗外科雜志, 2011, 28(3): 332-336.
6.	Jacquet P, Sugarbaker PH. Clinical research methodologies in diagnosis and staging of patients with peritoneal carcinomatosis. Cancer Treat Res, 1996, 82:359-374.
7.	鄭作深, 葉林, 李卓永. 肝癌轉移復發的研究進展. 現代生物醫學進展, 2009, 9(21): 4184-4186.
8.	Ravi S, Singal AK. Regorafenib:an evidence-based review of its potential in patients with advanced liver cancer. Core Evid, 2014, 9:81-87.
9.	蘆玉蘭, 江大瓊, 陳惠禎. 間歇性腫瘤細胞減滅術治療晚期卵巢癌的臨床價值探討. 中國實用婦科與產科雜志, 2005, 21(7):428-429.
10.	Esquivel J, Sticca R, Sugarbaker P, et al. Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in the management of peritoneal surface malignancies of colonic origin:a consensus statement. Society of Surgical Oncology. Ann Surg Oncol, 2007, 14(1):128-133.
11.	Roviello F, Caruso S, Marrelli D, et al. Treatment of peritoneal carci-nomatosis with cytoreductive surgery and hyperthermic intraperi-toneal chemotherapy:state of the art and future developments. Surg Oncol, 2011, 20(1):e38-e54.
12.	Rudloff U, Langan RC, Mullinax JE, et al. Impact of maximal cytore-ductive surgery plus regional heated intraperitoneal chemotherapy (HIPEC) on outcome of patients with peritoneal carcinomatosis of gastric origin:results of the GYMSSA trial. J Surg Oncol, 2014, 110(3):275-284.
13.	Harter P, Mahner S, Hilpert F, et al. Statement by the kommission OVAR of the AGO study group on the use of HIPEC (hyperthermic intraperitoneal chemotherapy) to treat primary and recurrent ovarian cancer. Geburtshilfe Frauenheilkd, 2013, 73(3):221-223.
14.	Ceelen W, Van Nieuwenhove Y, Putte DV, et al. Neoadjuvant chemo-therapy with bevacizumab may improve outcome after cytoreduc-tion and hyperthermic intraperitoneal chemoperfusion (HIPEC) for colorectal carcinomatosis. Ann Surg Oncol, 2014, 21(9):3023-3028.
15.	de Cuba EM, Kwakman R, Knol DL, et al. Cytoreductive surgery and HIPEC for peritoneal metastases combined with curative treatment of colorectal liver metastases:systematic review of all literature and meta-analysis of observational studies. Cancer Treat Rev, 2013, 39(4):321-327.

1. ?Jemal A, Bray F, Center MM, et al. Global cancer statistics. CA Cancer J Clin, 2011, 61(2):69-90.
2. Mazzaferro V, Bhoori S, Sposito C, et al. Milan criteria in liver transplantation for hepatocellular carcinoma:an evidence-based analysis of 15 years of experience. Liver Transpl, 2011, 17 Suppl 2:S44-S57.
3. Chua TC, Morris DL. Exploring the role of resection of extrahepatic metastases from hepatocellular carcinoma. Surg Oncol, 2012, 21(2):95-101.
4. 崔書中, 王佳泓, 張相良. 腫瘤細胞減滅術聯合腹腔熱灌注化療治療結直腸癌腹膜轉移癌. 中國腫瘤臨床, 2012, 39(22):1691-1695.
5. 唐利, 梅列軍, 李雁, 等. 細胞減滅術加腹腔熱灌注化療治療胃癌腹膜轉移癌. 中華實驗外科雜志, 2011, 28(3): 332-336.
6. Jacquet P, Sugarbaker PH. Clinical research methodologies in diagnosis and staging of patients with peritoneal carcinomatosis. Cancer Treat Res, 1996, 82:359-374.
7. 鄭作深, 葉林, 李卓永. 肝癌轉移復發的研究進展. 現代生物醫學進展, 2009, 9(21): 4184-4186.
8. Ravi S, Singal AK. Regorafenib:an evidence-based review of its potential in patients with advanced liver cancer. Core Evid, 2014, 9:81-87.
9. 蘆玉蘭, 江大瓊, 陳惠禎. 間歇性腫瘤細胞減滅術治療晚期卵巢癌的臨床價值探討. 中國實用婦科與產科雜志, 2005, 21(7):428-429.
10. Esquivel J, Sticca R, Sugarbaker P, et al. Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in the management of peritoneal surface malignancies of colonic origin:a consensus statement. Society of Surgical Oncology. Ann Surg Oncol, 2007, 14(1):128-133.
11. Roviello F, Caruso S, Marrelli D, et al. Treatment of peritoneal carci-nomatosis with cytoreductive surgery and hyperthermic intraperi-toneal chemotherapy:state of the art and future developments. Surg Oncol, 2011, 20(1):e38-e54.
12. Rudloff U, Langan RC, Mullinax JE, et al. Impact of maximal cytore-ductive surgery plus regional heated intraperitoneal chemotherapy (HIPEC) on outcome of patients with peritoneal carcinomatosis of gastric origin:results of the GYMSSA trial. J Surg Oncol, 2014, 110(3):275-284.
13. Harter P, Mahner S, Hilpert F, et al. Statement by the kommission OVAR of the AGO study group on the use of HIPEC (hyperthermic intraperitoneal chemotherapy) to treat primary and recurrent ovarian cancer. Geburtshilfe Frauenheilkd, 2013, 73(3):221-223.
14. Ceelen W, Van Nieuwenhove Y, Putte DV, et al. Neoadjuvant chemo-therapy with bevacizumab may improve outcome after cytoreduc-tion and hyperthermic intraperitoneal chemoperfusion (HIPEC) for colorectal carcinomatosis. Ann Surg Oncol, 2014, 21(9):3023-3028.
15. de Cuba EM, Kwakman R, Knol DL, et al. Cytoreductive surgery and HIPEC for peritoneal metastases combined with curative treatment of colorectal liver metastases:systematic review of all literature and meta-analysis of observational studies. Cancer Treat Rev, 2013, 39(4):321-327.

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Clinical Effect of Combination of Cytoreductive Surgery and Hyperthermic Intraperi-toneal Chemotherapy for Treating Hepatocellular Carcinoma with Peritoneal Metastasis

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