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

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.	崔书中, 王佳泓, 张相良. 肿瘤细胞减灭术联合腹腔热灌注化疗治疗结直肠癌腹膜转移癌. 中国肿瘤临床, 2012, 39(22):1691-1695.
5.	唐利, 梅列军, 李雁, 等. 细胞减灭术加腹腔热灌注化疗治疗胃癌腹膜转移癌. 中华实验外科杂志, 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.	郑作深, 叶林, 李卓永. 肝癌转移复发的研究进展. 现代生物医学进展, 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.	芦玉兰, 江大琼, 陈惠祯. 间歇性肿瘤细胞减灭术治疗晚期卵巢癌的临床价值探讨. 中国实用妇科与产科杂志, 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. 崔书中, 王佳泓, 张相良. 肿瘤细胞减灭术联合腹腔热灌注化疗治疗结直肠癌腹膜转移癌. 中国肿瘤临床, 2012, 39(22):1691-1695.
5. 唐利, 梅列军, 李雁, 等. 细胞减灭术加腹腔热灌注化疗治疗胃癌腹膜转移癌. 中华实验外科杂志, 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. 郑作深, 叶林, 李卓永. 肝癌转移复发的研究进展. 现代生物医学进展, 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. 芦玉兰, 江大琼, 陈惠祯. 间歇性肿瘤细胞减灭术治疗晚期卵巢癌的临床价值探讨. 中国实用妇科与产科杂志, 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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