Study On The Application Of Hyperthermic Intropertitoneal Chemotherapy In Colorectal Cancer Patients And Survival Analysis

Objective: To analyze the survival of patients with colorectal cancer treated with hyperthermic intraperitoneal chemotherapy(HIPEC),andto explore the factors influencing prognosis.Methods: This study was a retrospective cohort study.Patients with colorectal cancer who underwent HIPEC treatment from May 2018 to August2020 were screened through the case retrieval system of the Fourth Hospital of Hebei Medical University,and a total of 85 patients with complete clinicopathological data were enrolled and were followed up for survival.SPSS 26.0 statistical software was used for data analysis,and bivariate analysis,Kaplan-Meier method,Cox regression and Log Rank test were applied to explore the independent risk factors influencing long-term survival of colorectal cancer treated with hyperthermic intraperitoneal chemotherapy.Results:1.General data: of 85 patients enrolled,there were 47 male and 38 female,with a male-to-female ratio of 1.2:1.The age of patients is 26-85 years old,with a median age was 63 years.Pathological results indicated that there were 4 cases with TNM stage I(4.7%),26 with stage II(30.6%),23 with stage III(27.1%)and 32 with stage IV(37.6%).2.Complications: 10(11.8%)patients had adverse reactions after receiving Hyperthermic Intropertitoneal Chemotherapy,including 1(1.1%)anastomotic fistula,2(2.3%)abdominal distension and abdominal pain,4(4.7%)nausea and vomiting,1(1.1%)fever,2(2.3%)bone marrow suppression,and 3(3.5%)intestinal obstruction.3.The cumulative 6-month survival rate of the 85 colorectal cancerpatients with colorectal HIPEC was 88.2%,the 1-year cumulative urvival rate was 77.5%,and the 2-year cumulative survival rate was 42.45%,with a median survival time of 25 months(95% CI:13.723-36.277).4.Risk factor analysis: TNM stage(Kendall’s tau-b = 0.416,P<0.05),whether distant metastasis(Kendall’s tau-b= 0.369,P<0.05),mode of surgery(Kendall ’s tau-b =-0.404,P<0.05)and whether new metastases(Kendall’s tau-b = 0.234,P<0.05)were potential risk factors affecting survival prognosis in the cohort of patients with colorectal cancer treated with HIPEC.Surgical modality was an independent factor influencing survival in HIPEC-treated colorectal cancer patients(p=0.02).Conclusions:1.There was no significant correlation between different gender,age,tumor site,tumor pathological staging,tumor size,depth of infiltration,lymph node metastasis,whether lumpectomy was performed,whether MMR gene was missing,number of HIPIEC treatments,white blood cells,hemoglobin,lymphocytes,platelets,albumin,whether blood was transfused,NLR(neutrophil-lymphocyte ratio),PLR(platelet-lymphocyte ratio),etc.and whether patients with colorectalcancer treated with HIPEC survived as of the follow-up date.2.Patients who received intraperitoneal thermal perfusion chemotherapy did not have lethal serious complications,and only a fewpresent minor adverse reactions,and there was no clear correlation with HIPEC treatment.3.The 6-month cumulative survival rate of 85 colorectal cancer patients with HIPEC was 88.2%,the 1-year cumulative survival rate was77.5%,the 2-year cumulative survival rate was 42.45%,and the median survival time was 25 months.4.TNM stage,whether distant metastasis,surgical modality and whether new metastasis occurred were potential risk factors affecting thesurvival prognosis of the cohort of colorectal cancer patients treated with HIPEC.Surgical modality was an independent factor influencing the survival of colorectal cancer patients treated with HIPEC.