Does Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy Lead to Worse Quality of Life?

Caroline Ripat, GregoryTiesi, Omar Picado Roque, Danny Yakoub, Heather Stuart, Lilly Sánchez, Heidi Bahna, Floriano Marchetti and Mecker Möller

Department of Surgical Oncology, University of Miami, USA
Department of Surgery, Division of Colon and Rectum Surgery, University of Miami, USA
Sylvester Comprehensive Cancer Center, University of Miami, USA

^*Correspondance to: Mecker Moller 

 PDF  Full Text DOI: 10.25107/2474-1647.1237

Abstract

Background: Cytoreductive surgery with Hyperthermic Intraperitoneal Chemotherapy (CRS+HIPEC) is being utilized more frequently to treat peritoneal surface malignancies. However, extensive surgery is associated with significant postoperative morbidity and prolonged recovery. This study evaluates whether patients undergoing CRS+HIPEC experience decreased short-term quality of life (QoL).Methods: Patients scheduled for CRS+HIPEC for peritoneal malignancy were prospectively enrolled and completed the 26 item World Health Organization (WHOQOL-BREF) QoL questionnaire preoperatively and 3 months postoperatively; Questions assessed physical, psychological, social and environmental functioning; Patient demographics, treatment characteristics and morbidity were analyzed in conjunction with QoL scores.Results: 28 patients consented to participate. Of these, 17 patients completed both the preoperative and postoperative questionnaires, and 14 or 82% of these underwent CRS+HIPEC. Median ages of participants was 53 years, and most were Caucasian, non-Hispanic, and privately insured. Most patients had an ECOG status of 1. 53% of patients had an appendiceal primary tumor and 24% had comorbidities. 53% experienced R0 resection. Median ICU and hospital stay were 4 and 9 days respectively. Postoperative complications occurred in 35%, most frequently pleural effusion (18%), fistula formation (12%) and postoperative ileus (12%). Physical health scores increased postoperatively whereas psychological scores increased slightly. Increased time between questionnaires was associated with improved physical well-being scores and R2 resection with worse scores.Conclusion: Despite significant morbidity, patients who undergo CRS+HIPEC maintain QoL and satisfaction with their health. Patients may be counseled that in addition to potential prolongation of survival, postoperative QoL is generally preserved or improved after CRS+HIPEC.

Keywords

Cytoreductive surgery; Hyperthermic intraperitoneal chemotherapy; Hipec; Quality of life; Peritoneal carcinomatosis

Cite the article

Ripat C, Tiesi G, Roque OP, Yakoub D, Stuart H, Sanchez L, et al. Does Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy Lead to Worse Quality of Life? Clin Surg. 2016; 1: 1237.