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Quality of Life After Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy: Early Results from a Prospective Cohort Study of 115 Patients

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

Abstract

Background

This study aimed to describe short- and medium-term longitudinal quality-of-life (QoL) outcomes after cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC).

Methods

Consecutive patients undergoing CRS and HIPEC were recruited. The primary outcome was QoL, measured using the short-form 36 questionnaire and expressed as a physical component score (PCS) and a mental component score (MCS), with higher scores representing better QoL. Data were collected prospectively at baseline and before discharge, then 3, 6, and 12 months postoperatively. Trajectories of the PCS and MCS were described for the study period and grouped according to a peritoneal carcinomatosis index (PCI) (≤ 12 vs. ≥ 13) and a completeness of cytoreduction (CC) score (CC0 vs. CC1–CC3).

Results

Overall, 117 patients underwent CRS and HIPEC and 115 (98.3%) of the 117 patients participated in the study. The main primary pathology was colorectal in 52 (45%) of the 115 patients and appendiceal in 27 (23.5%) of the 115 patients. The median baseline PCS [48.16; interquartile range (IQR), 38.6–54.9] had decreased at pre-discharge (35.34; IQR, 28.7–41.8), then increased slightly at 3 months (42.54; IQR, 37.6–51.6), before returning to baseline within 6 months (48.35; IQR, 39.1–52.5) and remaining unchanged 12 months after surgery (48.55; IQR, 40.8–55.5). The MCS remained unchanged during the study period. The patients with a PCI of 13 or higher had worse PCS and MCS during the postoperative period than the patients with a PCI of 12 or lower.

Conclusions

The CRS and HIPEC procedures impaired PCS, with scores returning to baseline within 6 months after surgery, whereas MCS remained unchanged. The patients with a lower PCI had better postoperative QoL outcomes. For patients with peritoneal malignancy, CRS and HIPEC can be performed with acceptable short- to medium-term QoL outcomes.

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Acknowledgements

The authors thank the Surgical Outcomes Research Centre (SOuRCe) research staff and the Royal Prince Alfred Hospital clinical staff for their contribution and support toward this study.

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Authors and Affiliations

  1. Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital (RPAH), Sydney, NSW, Australia

    Daniel Steffens PhD, Cherry Koh MD, Nabila Ansari MD, Michael J. Solomon MD, PhD, Kilian Brown MD & Jane Young MD, PhD

  2. Faculty of Medicine and Health, The University of Sydney, Sydney, Australia

    Daniel Steffens PhD, Cherry Koh MD, Nabila Ansari MD, Michael J. Solomon MD, PhD, Kate McBride MHSM, Jane Young MD, PhD & Christopher J. Young MD

  3. Institute of Academic Surgery, Sydney Local Health District, Sydney, Australia

    Cherry Koh MD, Nabila Ansari MD, Michael J. Solomon MD, PhD, Kilian Brown MD & Christopher J. Young MD

  4. Department of Colorectal Surgery, Royal Prince Alfred Hospital, Sydney, Australia

    Cherry Koh MD, Michael J. Solomon MD, PhD, Kilian Brown MD, Kate McBride MHSM & Jane Young MD, PhD

  5. Peritoneal Malignancy Institute, Basingstoke, Basingstoke, UK

    Brendan Moran MD

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  1. Daniel Steffens PhD
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  2. Cherry Koh MD
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Correspondence to Daniel Steffens PhD.

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Steffens, D., Koh, C., Ansari, N. et al. Quality of Life After Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy: Early Results from a Prospective Cohort Study of 115 Patients. Ann Surg Oncol 27, 3986–3994 (2020). https://doi.org/10.1245/s10434-020-08443-4

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  • DOI: https://doi.org/10.1245/s10434-020-08443-4

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