Quality of Life in Patients after Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy: Is It Worth the Risk?

Quality of Life in Patients after Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy: Is It Worth the Risk?

Abstract

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.