Quality of life in patients after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy: Is it worth the risk?

TY - JOUR

T1 - Quality of life in patients after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy: Is it worth the risk?

AU - Tsilimparis, Nikolaos

AU - Bockelmann, Christina

AU - Raue, Wieland

AU - Menenakos, Charalambos

AU - Perez, Sebastian

AU - Rau, Beate

AU - Hartmann, Jens

PY - 2013/1

Y1 - 2013/1

N2 - Objective: To investigate the course of health-related quality of life (HQL) over time in patients with peritoneal carcinomatosis (PC) after complete cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC). Methods: Prospective, single-center, nonrandomized cohort study using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire. Results: Ninety patients who underwent CRS and HIPEC for PC in our institution were enrolled in the study. Mean age was 56 years (range 27-77 years) (61 % female). Primary tumor was colorectal in 21 %, ovarian in 19 %, pseudomyxoma peritonei in 16 %, an appendix tumor in 16 %, gastric cancer in 10 %, and peritoneal mesothelioma in 13 % of cases. Mean peritoneal carcinomatosis index was 22 (range 2-39). Mean global health status score was 69 ± 25 preoperatively and 55 ± 20, 66 ± 22, 66 ± 23, 71 ± 23, and 78 ± 21 at months 1, 6, 12, 24, and 36, respectively. Physical and role function recovered significantly at 6 months and were close to baseline at the 24-month measurement. Emotional function starting from a low baseline recovered to baseline by month 12. Cognitive and social function had slow recovery on follow-up. Fatigue, diarrhea, dyspnea, and sleep disturbance were symptoms persistent at 6-month follow-up, improving later on in survivors. Conclusions: Survivors after CRS and HIPEC have postoperative quality of life similar to preoperatively, with most of the reduced elements recovering after 6-12 months. We conclude that reduced quality of life of patients after CRS and HIPEC should not be used as an argument to deny surgical therapy to these patients.

AB - Objective: To investigate the course of health-related quality of life (HQL) over time in patients with peritoneal carcinomatosis (PC) after complete cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC). Methods: Prospective, single-center, nonrandomized cohort study using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire. Results: Ninety patients who underwent CRS and HIPEC for PC in our institution were enrolled in the study. Mean age was 56 years (range 27-77 years) (61 % female). Primary tumor was colorectal in 21 %, ovarian in 19 %, pseudomyxoma peritonei in 16 %, an appendix tumor in 16 %, gastric cancer in 10 %, and peritoneal mesothelioma in 13 % of cases. Mean peritoneal carcinomatosis index was 22 (range 2-39). Mean global health status score was 69 ± 25 preoperatively and 55 ± 20, 66 ± 22, 66 ± 23, 71 ± 23, and 78 ± 21 at months 1, 6, 12, 24, and 36, respectively. Physical and role function recovered significantly at 6 months and were close to baseline at the 24-month measurement. Emotional function starting from a low baseline recovered to baseline by month 12. Cognitive and social function had slow recovery on follow-up. Fatigue, diarrhea, dyspnea, and sleep disturbance were symptoms persistent at 6-month follow-up, improving later on in survivors. Conclusions: Survivors after CRS and HIPEC have postoperative quality of life similar to preoperatively, with most of the reduced elements recovering after 6-12 months. We conclude that reduced quality of life of patients after CRS and HIPEC should not be used as an argument to deny surgical therapy to these patients.

UR - http://www.scopus.com/inward/record.url?scp=84871785146&partnerID=8YFLogxK

U2 - 10.1245/s10434-012-2579-9

DO - 10.1245/s10434-012-2579-9

M3 - SCORING: Journal article

C2 - 22868919

AN - SCOPUS:84871785146

VL - 20

SP - 226

EP - 232

JO - ANN SURG ONCOL

JF - ANN SURG ONCOL

SN - 1068-9265

IS - 1

ER -