Therapeutic Effect Of Hepatectomy Combined With Hyperthermic Intraperitoneal Chemotherapy On The Rupture And Hemorrhage Of Primary Liver Cancer

Objective:To investigate the clinical efficacy of hepatectomy+hyperthermic intraperitoneal chemotherapy(HIPEC)in the treatment of ruptured and bleeding of primary liver cancer,and to analyze and evaluate the efficacy and safety of hyperthermic intraperitoneal chemotherapy in the treatment of ruptured and bleeding of primary liver cancer in detail.Methods:The clinical baseline data of 55 patients with rupture and hemorrhage of primary liver cancer who underwent hepatectomy and were pathologically confirmed from May 2015 to may 2020 in our hospital were included.26 patients with primary hepatocellular carcinoma rupture and hemorrhage who received hepatectomy combined with HIPEC were included in the experimental group,and 29 patients with primary hepatocellular carcinoma rupture and hemorrhage who received simple hepatectomy were included in the control group.The preoperative baseline data of the two groups were analyzed statistically to determine the comparability between the two groups.Univariate and multivariate analyses were carried out using Cox regression scale model to identify independent protective factors and independent risk factors related to postoperative recurrence and death of patients with rupture and hemorrhage of primary liver cancer.The Kaplan-Meier method was used for survival analysis.Result:The baseline data characteristics of patients in the hepatectomy+HIPEC group and the hepatectomy group were comparable(P>0.05);The mean length of hospital stay in the hepatectomy+HIPEC group was longer than that in the hepatectomy group(P<0.05).The difference in the transfer rate of peritoneal cavity implantation metastasis between the two groups was statistically significant(P<0.05).There was no significant difference between the two groups of patients receiving anti-tumor and anti-viral therapy after surgery(P>0.05).In terms of long-term survival,the hepatectomy+HIPEC group showed better overall survival(OS)and disease-free survival(DFS),and the median survival time in the hepatectomy+HIPEC group was longer than that in the hepatectomy group(17.0 months vs.13.0 months),with statistically significant difference between groups(x~2=5.107,P<0.05).The overall survival rates at 6-months,12-months and 18-months in the hepatectomy+HIPEC group were 84.6%,65.4%and 42.3%,respectively.The overall survival rates at 6-months,12-months and 18-months in the hepatectomy group were 75.9%,51.7%and 13.8%,respectively.The median disease-free survival(DFS)of the hepatectomy+HIPEC group was better than that of the simple hepatectomy group(12 months vs.7 months).(x~2=3.914,P<0.05).The disease-free survival rates at 6-months,12-months and 18-months in the hepatectomy+HIPEC group were 76.9%,46.2%and 34.6%,respectively.The disease-free survival rates at 6-months,12-months and 18 months in the hepatectomy group were 55.2%,13.8%and10.3%respectively.Cox regression analysis showed that hepatectomy combined with HIPEC was an independent protective factor for tumor recurrence(HR=2.194,P<0.05)and prognosis(HR=2.234,P<0.05)in patients with rupture and hemorrhage of primary liver cancer.Conclusion:1.Hyperthermic intraperitoneal chemotherapy is an independent protective factor for postoperative recurrence and prognosis of patients with rupture and hemorrhage of primary liver cancer;Hyperthermic intraperitoneal chemotherapy can effectively reduce the incidence of postoperative peritoneal cavity implantation metastasis in patients with primary liver cancer ruptured and bleeding.2.Hyperthermic intraperitoneal chemotherapy can improve the survival time and disease-free survival of patients with rupture and hemorrhage of primary liver cancer after hepatectomy,but the long-term efficacy still needs to be further studied.