Clinical Efficacy Of Intraperitoneal Hyperthermic Chemotherapy In The Treatment Of Advanced Gallbladder Cancer

Objective To investigate the clinical efficacy of intraperitoneal hyperthermic perfusion chemotherapy(HIPEC)in the treatment of advanced gallbladder cancer and assess the safety and efficacy of intraperitoneal hyperthermic chemotherapy in the treatment of advanced gallbladder cancer.provide evidence for the application of intraperitoneal hyperthermic chemotherapy in the study of biliary malignancies.Methods The clinical data of 46 patients with advanced gallbladder cancer who were treated by surgery from October 1,2015 to November 1,2017 were analyzed retrospectively.Among them,15 patients were treated with HIPEC during operation and after operation(group surgery +HIPEC),and the other 31 patients received surgical treatment only(group.surgery).The general data of the two groups were compared before operation,such as gender,age,surface area and whether the stones were combined.The operative time,hospitalization days,liver function and renal function between the two groups were compared.The body temperature at the beginning of operation and the changes of body temperature at Oh,6,12h,18h,24h after operation.Analysis of histopathological characteristics.Observation of postoperative side effects and complications in the two groups.The short-term survival and recurrence were followed up by outpatient or telephone.The end of the follow-up was the death or follow-up time of the patients as of February 1,2018.Result The surgery + HIPEC group included 12 cases of TNM stageⅢand 3 cases of stage ⅣA,and each performed 2.1 times of HIPEC.Thirty-one patients in the surgery group included 25 cases of TNM stage Ⅲand 6 cases of stage ⅣA.There was no significant difference in sex,age,body surface area,combined stone and operation time between the two groups(P>0.05).The average length of hospital stay in surgery + HIPEC group was 23.13 ± 5.4 days,which was longer than that in surgery group(19.26 ± 3.5days)(P<0.05).There was no difference in preoperative body temperature,while surgery HIPEC group had higher body temperature at Oh and 6h than those in the surgery group alone(P<0.05).The body temperature in both groups gradually became the same after 12h-24h.There were no significant differences in tumor size,tumor location,TNM stage,and aggressive nerves between the two groups.No postoperative liver and kidney damage occurred in both groups.There was no significant difference in postoperative side effects and complications between the two groups(P>0.05).The median follow-up time was 12.5 months.The median survival time of surgery +HIPEC group(13.4 ± 5.7 months)was longer than that of surgery group patients(9.4 ± 6.9 months).Log-rank test showed that the survival difference was χ2=3.866,P=0.049.The half-year survival rates of the two groups were 80%、73.7%,and the 1 year survival rates were 60%vs 42.9%respectively.The half-year survival rates of the two groups were 80%and 73.7%,respectively.The 1 year survival rates were 60%and 42.9%respectively.Conclusion Treatment of advanced gallbladder cancer with HIPEC does not increase postoperative adverse reactions and complications.Data analysis shows that HIPEC prolongs the patient’s hospital stay,but HIPEC can prolong the survival of patients with advanced gallbladder cancer,But more information and further follow-up are needed for long-term survival and survival.