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01-09-2016 | Gastrointestinal Oncology

Impact of Major Complications on Patients’ Quality of Life After Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy

Authors: Trevor D. Hamilton, MD, Emily L. Taylor, BSc, Amanda J. Cannell, BSc, J. Andrea McCart, MD, MSc, Anand Govindarajan, MD, MSc

Published in: Annals of Surgical Oncology | Issue 9/2016

Abstract

Introduction

Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) is an effective treatment for selected patients with peritoneal surface malignancies (PSM). Although it can have significant morbidity, perioperative mortality is low. Little is known about whether major complications after CRS/HIPEC have a lasting impact on patients’ quality of life (QOL).

Methods

We retrospectively reviewed data from a prospectively collected database on patients treated with CRS/HIPEC for PSM (2011–2014). Patients with CRS/HIPEC and 6-month QOL evaluation were included. Major perioperative complications (Clavien–Dindo grade 3/4) were the primary independent variable. QOL was evaluated using the validated EORTC QLQ-C30 score. The primary outcome was 6-month global health score. Secondary outcomes were individual functional and symptom domains.

Results

Forty-two patients were analyzed. Median age was 57.5; 64 % were female. Origin of PSM was appendix (55 %), colorectal (38 %), mesothelioma (5 %), and small bowel (2 %). Fourteen patients (33 %) had major (grade 3/4) complications. Median length of stay was 16 days; patients experiencing major complications had significantly increased length of stay (35.5 vs. 13 days, p < 0.01). Major complications included intra-abdominal abscess (9.5 %), bleeding (9.5 %), symptomatic pleural effusion (7.1 %), anastomotic leaks (7.1 %), and renal failure (2.4 %). The average global health score at 6 months was 68.1. The worst-rated symptom scores at 6 months were diarrhea (39.8) and fatigue (35.4). There were no significant differences in 6-month QOL scores between patients with and without major complications, globally or in specific domains.

Conclusions

Although major complications are common after CRS/HIPEC, QOL at 6 months recovers and is similar to those without major complications.

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Title: Impact of Major Complications on Patients’ Quality of Life After Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy
Authors: Trevor D. Hamilton, MD
Emily L. Taylor, BSc
Amanda J. Cannell, BSc
J. Andrea McCart, MD, MSc
Anand Govindarajan, MD, MSc
Publication date: 01-09-2016
Publisher: Springer International Publishing
Published in: Annals of Surgical Oncology / Issue 9/2016
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-016-5231-2

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Springer Medicine

Impact of Major Complications on Patients’ Quality of Life After Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy

Abstract

Introduction

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusions

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