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已发表论文
腹腔热灌注化疗对自发破裂肝细胞癌根治性切除术后预防作用的回顾性研究
Authors Li Z , Lin J, Gao K, Dang X, Hua Y
Received 4 September 2025
Accepted for publication 9 December 2025
Published 22 December 2025 Volume 2025:17 Pages 3241—3258
DOI https://doi.org/10.2147/CMAR.S555348
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Chien-Feng Li
Zhichao Li, Junlong Lin, Kai Gao, Xi Dang, Yunpeng Hua
Hepatobiliary and Pancreatic Center, the First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, People’s Republic of China
Correspondence: Yunpeng Hua, Email hyp0427@163.com
Background: Spontaneous rupture of hepatocellular carcinoma (srHCC) carries a high risk of peritoneal metastasis and poor prognosis. While hyperthermic intraperitoneal chemotherapy (HIPEC) is established for peritoneal metastases in other cancers, its prophylactic role after radical resection of srHCC remains undefined. This study evaluated the efficacy and safety of HIPEC in improving outcomes for srHCC patients post-hepatectomy.
Methods: In this retrospective study, 77 patients with srHCC undergoing hepatectomy (2016– 2022) were categorized into the HR-HIPEC group (n=30) and the non-HIPEC group (n=47). Clinical features and survival data were analyzed.
Results: The HR-HIPEC group demonstrated significantly superior median overall survival (OS: 44 vs 35 months; P=0.027) and recurrence-free survival (RFS: 44 vs 25 months; P=0.007). The 3-year OS (73.85% vs 44.17%) and RFS (54.72% vs 24.47%) rates were also higher with HIPEC. Multivariate analysis identified HIPEC as an independent protective factor for both OS (HR=9.301, P< 0.001) and RFS (HR=2.159, P=0.044). Postoperative recovery, morbidity, and mortality were comparable between groups. Subgroup analysis of HIPEC regimens (gemcitabine/cisplatin vs oxaliplatin/5-FU/folinic acid) revealed no significant differences in efficacy, though the latter was associated with transiently lower hemoglobin (P=0.006).
Conclusion: Prophylactic HIPEC is a safe and feasible adjunct to hepatectomy that significantly improves survival outcomes in srHCC patients without increasing perioperative risks. The choice between the two chemotherapy regimens studied did not affect efficacy, warranting further investigation to optimize protocols.
Keywords: liver resection, hepatocellular carcinoma, hyperthermic intraperitoneal chemotherapy
Hepatobiliary and Pancreatic Center, the First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, People’s Republic of China
Correspondence: Yunpeng Hua, Email hyp0427@163.com
Background: Spontaneous rupture of hepatocellular carcinoma (srHCC) carries a high risk of peritoneal metastasis and poor prognosis. While hyperthermic intraperitoneal chemotherapy (HIPEC) is established for peritoneal metastases in other cancers, its prophylactic role after radical resection of srHCC remains undefined. This study evaluated the efficacy and safety of HIPEC in improving outcomes for srHCC patients post-hepatectomy.
Methods: In this retrospective study, 77 patients with srHCC undergoing hepatectomy (2016– 2022) were categorized into the HR-HIPEC group (n=30) and the non-HIPEC group (n=47). Clinical features and survival data were analyzed.
Results: The HR-HIPEC group demonstrated significantly superior median overall survival (OS: 44 vs 35 months; P=0.027) and recurrence-free survival (RFS: 44 vs 25 months; P=0.007). The 3-year OS (73.85% vs 44.17%) and RFS (54.72% vs 24.47%) rates were also higher with HIPEC. Multivariate analysis identified HIPEC as an independent protective factor for both OS (HR=9.301, P< 0.001) and RFS (HR=2.159, P=0.044). Postoperative recovery, morbidity, and mortality were comparable between groups. Subgroup analysis of HIPEC regimens (gemcitabine/cisplatin vs oxaliplatin/5-FU/folinic acid) revealed no significant differences in efficacy, though the latter was associated with transiently lower hemoglobin (P=0.006).
Conclusion: Prophylactic HIPEC is a safe and feasible adjunct to hepatectomy that significantly improves survival outcomes in srHCC patients without increasing perioperative risks. The choice between the two chemotherapy regimens studied did not affect efficacy, warranting further investigation to optimize protocols.
Keywords: liver resection, hepatocellular carcinoma, hyperthermic intraperitoneal chemotherapy