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Impairments in Bowel Function, Social Function and Quality of Life After Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy

  • Peritoneal Surface Malignancy
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) can be associated with decreases in quality of life (QOL). Bowel-related QOL (BR-QOL) after CRS-HIPEC has not been previously studied. The objectives of the current study were to examine the effect of different types of bowel resection during CRS-HIPEC on overall QOL and BR-QOL.

Methods

A prospective cohort study was performed. QOL data were collected using the European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 and CR-29 questionnaires at 3, 6, and 12 months after CRS-HIPEC. Patients were divided into groups that underwent no bowel resection, non-low anterior resection (LAR) bowel resection, LAR, and LAR with stoma. Primary outcomes were global QOL and BR-QOL.

Results

Overall, 158 patients were included in this study. Bowel resections were performed in 77% of patients, with 31% undergoing LAR. Global QOL was not significantly different between groups. LAR patients (with and without stoma) had significantly worse BR-QOL, embarrassment, and altered body image, with LAR + stoma patients having the largest impairments in these domains. Trends toward higher levels of impotence and anxiety were also seen in LAR patients. Although global QOL improved over time, impairments in BR-QOL and sexual and social function did not significantly improve over time.

Conclusions

Although global QOL after CRS-HIPEC was not affected by the type of bowel resection, the use of LAR and ostomies was associated with clinically meaningful and persistent impairments in BR-QOL and related functional domains. Generic QOL questionnaires may not adequately capture these domains; however, targeted questionnaires in these patients may help improve QOL after CRS-HIPEC.

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Acknowledgment

The authors would like to acknowledge Janna Maier for her assistance with data entry of the prospectively collected QOL questionnaires.

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Authors and Affiliations

  1. Division of General Surgery, Department of Surgery, University of Toronto, Toronto, ON, Canada

    Zubair Bayat MD, Danielle A. Bischof MD, FRCSC, J. Andrea McCart MD, FRCSC & Anand Govindarajan MD, FRCSC

  2. Mount Sinai Hospital, Sinai Health System, Toronto, ON, M5G 1X5, USA

    Emily L. Taylor CCRP, Danielle A. Bischof MD, FRCSC, J. Andrea McCart MD, FRCSC & Anand Govindarajan MD, FRCSC

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  1. Zubair Bayat MD
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  2. Emily L. Taylor CCRP
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  3. Danielle A. Bischof MD, FRCSC
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  4. J. Andrea McCart MD, FRCSC
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  5. Anand Govindarajan MD, FRCSC
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Correspondence to Anand Govindarajan MD, FRCSC.

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Bayat, Z., Taylor, E.L., Bischof, D.A. et al. Impairments in Bowel Function, Social Function and Quality of Life After Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy. Ann Surg Oncol 27, 124–131 (2020). https://doi.org/10.1245/s10434-019-07385-w

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  • DOI: https://doi.org/10.1245/s10434-019-07385-w

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