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Efficacy of Laparoscopic Radical Surgery combined with Intraperitoneal Hyperthermic Perfusion Chemotherapy on Advanced Rectal Cancer and Its Effects on Levels of Serum TK1, COX-2 and VEGF |
WU Lei, MENG Yong, CHENG Si |
Xianning Central Hospital, Hubei Xianning 437100, China |
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Abstract Objective: To investigate the efficacy of laparoscopic radical surgery combined with intraperitoneal hyperthermic perfusion chemotherapy in the treatment of advanced rectal cancer and its effects on levels of serum thymidine kinase 1 (TK1), cyclooxygenase-2 (COX-2) and vascular endothelial growth factor (VEGF). Methods: 100 patients with advanced rectal cancer in our hospital were observed. 43 patients in single group underwent laparoscopic radical surgery, and 57 patients in combined group underwent laparoscopic radical surgery combined with intraperitoneal hyperthermic perfusion chemotherapy. The therapeutic effects, occurrence of complications, recurrence, metastasis and survival, levels of serum TK1, COX-2 and VEGF and physical function status were observed in the two groups. Results: After treatment, the total effective rate in combined group was significantly higher than that in single group (78.95% vs 58.14%) (P<0.05). The incidence rates of anastomotic leakage, stump fistula, abdominal infection, intestinal obstruction and myelosuppression during treatment in combined group were not significantly different from those in single group (P>0.05). The recurrence rate and metastasis rate in combined group were significantly lower than those in single group while the 2-year survival rate was significantly higher than that in single group (P<0.05), and the progression-free survival rate in combined group was significantly higher than that in single group (P<0.05). After treatment, the decreases of serum TK1, COX-2 and VEGF in combined group were greater than those in single group (P<0.05). There were significant differences in the group effects, time effects and interaction effects of KPS (P<0.05), and the KPS scores at 1 year and 2 years after surgery in combined group were significantly higher than those in single group (P<0.05), and the KPS scores in the two groups were significantly increased at 1 year and 2 years after surgery (P<0.05). Conclusion: Laparoscopic radical surgery combined with intraperitoneal hyperthermic perfusion chemotherapy has exact efficacy and low incidence rate of complications in the treatment of advanced rectal cancer, and it can help reduce the tumor recurrence rate and metastasis rate, improve the survival, regulate the levels of serum TK1, COX-2 and VEGF and inhibit tumor cell proliferation, and it is conducive to the recovery of physical function.
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