Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 1/2013

01-01-2013 | Gastrointestinal Oncology

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

Authors: Nikolaos Tsilimparis, MD, Christina Bockelmann, MD, Wieland Raue, MD, Charalambos Menenakos, MD, Sebastian Perez, MSPH, Beate Rau, MD, PhD, Jens Hartmann, MD, PhD

Published in: Annals of Surgical Oncology | Issue 1/2013

Login to get access

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.
Literature
1.
Glehen O, Beaujard AC, Arvieux C, Huber O, Gilly FN. Peritoneal carcinomatosis. Surgical treatment, peritonectomy and intraperitoneal chemohyperthermia. Gastroenterol Clin Biol. 2002;26:210–215.PubMed
2.
Verwaal VJ, van Ruth S, de Bree E, van Sloothen GW, van Tinteren H, Boot H, et al. Randomized trial of cytoreduction and hyperthermic intraperitoneal chemotherapy versus systemic chemotherapy and palliative surgery in patients with peritoneal carcinomatosis of colorectal cancer. J Clin Oncol. 2003;21:3737–3743.PubMedCrossRef
3.
Sugarbaker PH. New standard of care for appendiceal epithelial neoplasms and pseudomyxoma peritonei syndrome? Lancet Oncol. 2006;7:69–76.PubMedCrossRef
4.
Gill RS, Al-Adra DP, Nagendran J, Campbell S, Shi X, Haase E, et al. Treatment of gastric cancer with peritoneal carcinomatosis by cytoreductive surgery and HIPEC: a systematic review of survival, mortality, and morbidity. J Surg Oncol. 2011;104:692–698.PubMedCrossRef
5.
Yang XJ, Huang CQ, Suo T, Mei LJ, Yang GL, Cheng FL, et al. Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy improves survival of patients with peritoneal carcinomatosis from gastric cancer: Final results of a phase III randomized clinical trial. Ann Surg Oncol. 2011;18:1575–1581.PubMedCrossRef
6.
Yan TD, Deraco M, Baratti D, Kusamura S, Elias D, Glehen O, et al. Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for malignant peritoneal mesothelioma: multi-institutional experience. J Clin Oncol. 2009;27:6237–6242.PubMedCrossRef
7.
Gray NM, Hall SJ, Browne S, Macleod U, Mitchell E, Lee AJ, et al. Modifiable and fixed factors predicting quality of life in people with colorectal cancer. Br J Cancer. 2011;104:1697–1703.PubMedCrossRef
8.
Piso P, Glockzin G, von Breitenbuch P, Popp FC, Dahlke MH, Schlitt HJ, et al. Quality of life after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for peritoneal surface malignancies. J Surg Oncol. 2009;100:317–320.PubMedCrossRef
9.
Hill AR, McQuellon RP, Russell GB, Shen P, Stewart JHt, Levine EA. Survival and quality of life following cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy for peritoneal carcinomatosis of colonic origin. Ann Surg Oncol. 2011;18:3673–3679.PubMedCrossRef
10.
Raue W, Tsilimparis N, Langelotz C, Rau B, Schwenk W, Hartmann J. Initial results after implementation of a multimodal treatment for peritoneal malignancies. Acta Chir Belg. 2011;111:68–72.PubMed
11.
Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6,336 patients and results of a survey. Ann Surg. 2004;240:205–213.PubMedCrossRef
12.
Clavien PA, Barkun J, de Oliveira ML, Vauthey JN, Dindo D, Schulick RD, et al. The Clavien–Dindo classification of surgical complications: five-year experience. Ann Surg. 2009;250:187–196.PubMedCrossRef
13.
Hox J. Multilevel analysis. Techniques and applications. 2nd ed. New York, Routledge; 2010.
14.
Schwarz R, Hinz A. Reference data for the quality of life questionnaire EORTC QLQ-C30 in the general German population. Eur J Cancer. 2001;37:1345–1351.PubMedCrossRef
15.
McQuellon R, Gavazzi C, Piso P, Swain D, Levine E. Quality of life and nutritional assessment in peritoneal surface malignancy (PSM): Recommendations for care. J Surg Oncol. 2008;98:300–305.PubMedCrossRef
16.
McQuellon RP, Danhauer SC, Russell GB, Shen P, Fenstermaker J, Stewart JH, et al. Monitoring health outcomes following cytoreductive surgery plus intraperitoneal hyperthermic chemotherapy for peritoneal carcinomatosis. Ann Surg Oncol. 2007;14(3):1105–1113
17.
Cocks K, King MT, Velikova G, Fayers PM, Brown JM. Quality, interpretation and presentation of European Organisation for Research and Treatment of Cancer quality of life questionnaire core 30 data in randomised controlled trials. Eur J Cancer. 2008;44:1793–1798.PubMedCrossRef
18.
Cocks K, King MT, Velikova G, Martyn St-James M, Fayers PM, Brown JM. Evidence-based guidelines for determination of sample size and interpretation of the European Organisation for the Research and Treatment of Cancer quality of life questionnaire core 30. J Clin Oncol. 2010;29:89–96.PubMedCrossRef
19.
Schmidt U, Dahlke MH, Klempnauer J, Schlitt HJ, Piso P. Perioperative morbidity and quality of life in long-term survivors following cytoreductive surgery and hyperthermic intraperitoneal chemotherapy. Eur J Surg Oncol. 2005;31:53–58.PubMedCrossRef
20.
McQuellon RP, Loggie BW, Fleming RA, Russell GB, Lehman AB, Rambo TD. Quality of life after intraperitoneal hyperthermic chemotherapy (iphc) for peritoneal carcinomatosis. Eur J Surg Oncol. 2001;27:65–73.PubMedCrossRef
21.
McQuellon RP, Loggie BW, Lehman AB, Russell GB, Fleming RA, Shen P, et al. Long-term survivorship and quality of life after cytoreductive surgery plus intraperitoneal hyperthermic chemotherapy for peritoneal carcinomatosis. Ann Surg Oncol. 2003;10:155-162.PubMedCrossRef
22.
Tuttle TM, Zhang Y, Greeno E, Knutsen A. Toxicity and quality of life after cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy. Ann Surg Oncol. 2006;13:1627–1632.PubMedCrossRef
23.
Jess P, Iversen LH, Nielsen MB, Hansen F, Laurberg S, Rasmussen PC. Quality of life after cytoreductive surgery plus early intraperitoneal postoperative chemotherapy for pseudomyxoma peritonei: a prospective study. Dis Colon Rectum. 2008;51:868–874.PubMedCrossRef
24.
Glockzin G, Schlitt HJ, Piso P. Peritoneal carcinomatosis: patients selection, perioperative complications and quality of life related to cytoreductive surgery and hyperthermic intraperitoneal chemotherapy. World J Surg Oncol. 2009;7:5.PubMedCrossRef
25.
Zenasni F, Botella M, Elias D, Dauchy S, Boige V, Malka D, et al. The long-term impact of hyperthermic intraperitoneal chemotherapy on survivors treated for peritoneal carcinomatosis: a cross-sectional study. Support Care Cancer. 2009;17:1255–1261.PubMedCrossRef
Metadata
Title
Quality of Life in Patients after Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy: Is It Worth the Risk?
Authors
Nikolaos Tsilimparis, MD
Christina Bockelmann, MD
Wieland Raue, MD
Charalambos Menenakos, MD
Sebastian Perez, MSPH
Beate Rau, MD, PhD
Jens Hartmann, MD, PhD
Publication date
01-01-2013
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 1/2013
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-012-2579-9

Other articles of this Issue 1/2013

Annals of Surgical Oncology 1/2013 Go to the issue

Breast Oncology

A Comparison of Clinical and Pathologic Assessments for the Prediction of Occult Nipple Involvement in Nipple-Sparing Mastectomies

Melanomas

Minimally Invasive Inguinal Lymph Node Dissection (MILND) for Melanoma: Experience from Two Academic Centers

Breast Oncology

Complete Axillary Lymph Node Dissection Versus Clinical Follow-up in Breast Cancer Patients with Sentinel Node Micrometastasis: Final Results from the Multicenter Clinical Trial AATRM 048/13/2000

Hepatobiliary Tumors

A Systematic Review of Microvascular Invasion in Hepatocellular Carcinoma: Diagnostic and Prognostic Variability

Colorectal Cancer

Definition of Patients Presenting a High Risk of Developing Peritoneal Carcinomatosis After Curative Surgery for Colorectal Cancer: A Systematic Review

Colorectal Cancer

Detailed Pathologic Characteristics of the Primary Colorectal Tumor Independently Predict Outcome after Hepatectomy for Metastases