39例腹膜假粘液瘤生存预后分析

Evaluating the Survival and Identifying Prognostic Factors of 39 Cases Pseudomyxoma Peritonei

目的探讨腹膜假性粘液瘤的临床病理特征并分析其生存预后。方法回顾性分析我院2002年5月～2011年12月收治的39例腹膜假粘液瘤患者的临床及随访资料,运用单因素及多因素统计分析方法,寻找影响患者生存期的预后因素。结果全部患者行手术治疗,32例行单纯术中腹腔化疗,7例行腹腔内热化疗。中位随访时间为40个月,随访期内9例患者死亡,其中1例为腹腔内热化疗患者。5年、10年生存率分别为89.0%和35.0%。中位生存期为37个月。单因素分析显示术前肿瘤标志物高于正常及病理分型为腹膜粘液腺瘤病者对生存期延长有统计意义(P=0.027,P=0.048)。多因素分析显示病理类型可作为影响总生存的独立预后因素(P=0.033)。结论术前肿瘤标志物水平可在一定程度上影响患者生存。病理组织分型在影响患者生存期的因素中仍占主导地位。

Objective To investigate the clinical characteristics of pseudomyxoma peritonei,analyze survival and identify prognostic factors.Method A total of 39 patients treated at our hospital between 2002 and 2011 were identified.A retrospective study was conducted to demonstrate the prognostic factors with univariate and multivariate analyses.Result All patients received operation and 7 patients received intraoperative hyperthermic intraperitoneal chemotherapy（HIPEC） after operation.The median follow up was 40 months.There were 9 deaths in this period,1 of them received HIPEC.The 5-and 10-year survival rates were 89.0% and 35.0%,respectively.The medians of overall survival time was 37 months.Univariate analyses revealed pathologic type and preoperative level of tumor markers did exert an impact on overall survival time（P=0.048,P=0.027）.The multivariate analysis identified pathologic type（P=0.033）as an independent prognostic influence on survival.Conclusion The pathologic subtype remains the dominant factor for survival.Normal baseline level with tumor markers seems to have a better survival result.