Quality of life after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for peritoneal surface malignancies

Piso, Pompiliu; Glockzin, Gabriel; Breitenbuch, P von; Popp, Felix; Dahlke, Marc H.; Schlitt, Hans J.; Nissan, Aviram

doi:10.1002/jso.21327

Cited by 38 publications

(14 citation statements)

References 35 publications

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“…Good or acceptable quality of life had been suggested by previous studies [10,11,20,] but their interpretation was limited by the fact that data had been collected retrospectively. Hill et al, in their prospective analysis of patients with peritoneal carcinomatosis of colonic origin, found a pattern of recovery similar to our patients with the exception of emotional function, which was significantly improved in their study not including ovarian cancer patients [18].…”

Section: Discussionmentioning

confidence: 99%

Quality of Life in Peritoneal Carcinomatosis: A Prospective Study in Patients Undergoing Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy (HIPEC)

et al. 2014

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Background/Aims: Cytoreductive surgery and hyperthermic intraperitoneal chemoperfusion (HIPEC) can improve survival in selected patients with peritoneal carcinomatosis, but bear a significant risk of perioperative morbidity. The aim of this study was to prospectively evaluate the quality of life (QoL) following cytoreduction and HIPEC. Methods: In this study including 40 patients (65% females) with different primary tumors, the EORTC QLQ-C30 questionnaire was applied prior to CS and HIPEC as well as 3, 9, and 18 months postoperatively. Results: Global health status was not impaired significantly following HIPEC. Scales and symptom scores that deteriorated 3 months postoperatively (p < 0.05), that is, physical, role, and social functions as well as fatigue, pain, dyspnea, insomnia, and diarrhea, all returned to preoperative values within 9 months. Conclusions: Following cytoreductive surgery and HIPEC, QoL returns to preoperative levels within 9 months. Selected patients that are likely to benefit oncologically from HIPEC should not be denied this option for fear of reduced postoperative QoL. i 2014 S. Karger AG, Basel

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Section: Discussionmentioning

confidence: 99%

Quality of Life in Peritoneal Carcinomatosis: A Prospective Study in Patients Undergoing Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy (HIPEC)

et al. 2014

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“…27,28 Studies designed to measure elements of quality of life prior to and following CRS– HIPEC have documented postoperative declines in physical well-being and physical functioning, as well as significant depressive symptoms that persist for at least a year in up to a third of patients. 17,29–31 While emotional well-being was reported to improve after CRS–HIPEC, and physical well-being and function were found to return to baseline between 6 and 12 months after surgery, these studies were limited by reporting bias, since patients with poor quality of life may have selectively dropped out during the follow-up period.…”

Section: Discussionmentioning

confidence: 99%

Extensive Cytoreductive Surgery for Appendiceal Carcinomatosis: Morbidity, Mortality, and Survival

et al. 2013

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Background Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemoperfusion (HIPEC) are frequently used to treat appendiceal carcinomatosis. Some patients require multivisceral resection because of the volume of disease. It is unclear whether extent of CRS impacts survival in appendiceal carcinomatosis. Methods We analyzed 282 patients undergoing attempted CRS/HIPEC for appendiceal carcinomatosis. Patients were defined as having undergone Extensive CRS (n = 60) if they had >3 organ resections or >2 anastomoses; a subgroup of Extreme CRS patients (n = 10) had ≥5 organ resections and ≥3 anastomoses. Kaplan–Meier survival curves and multivariate Cox-regression models were used to identify prognostic factors affecting outcomes. Results Relative to the comparison group, patients undergoing Extensive CRS had a higher median peritoneal carcinomatosis index, operative duration, blood loss, and length of stay. No difference in completeness of cytoreduction, severe morbidity, or 60-day mortality was evident. Subgroup analysis of 10 patients undergoing extreme CRS likewise revealed no increase in severe morbidity or mortality. Median progression-free (PFS) and overall survival (OS) were 23.5 and 74 months in the comparison group; 18.5 (p = 0.086) and 51 (p = 0.85) months in the Extensive CRS group; and 40 months and not reached in the Extreme CRS subgroup. In a multivariable analysis, extent of CRS was not independently associated with PFS or OS. Conclusions Extensive CRS is associated with greater OR time, blood loss, and length of stay, but is not associated with higher morbidity, mortality, or inferior oncologic outcomes in patients with appendiceal carcinomatosis.

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“…Postoperative morbidity lowers quality of life. When patients recover from CRS + HIPEC, quality of life will also restore, and after 3–4 months, most patients return to baseline or better functioning [28, 29]. However, postoperative complications can significantly decrease quality of life, and this must be avoided at all times.…”

Section: Discussionmentioning

confidence: 99%

Rhabdomyolysis after Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy: A Case Report

Bielen¹,

Verswijvel

Speeten³

2013

Case Rep Oncol

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Gastric cancer with peritoneal carcinomatosis is a disease with a poor prognosis. Cytoreductive surgery (CRS) and hyperthermic intraperitoneal perioperative chemotherapy (HIPEC) can improve prognosis, although in most cases this should still be considered as a palliative treatment. Therefore, morbidity has to be avoided at all cost as quality of life is of utmost importance. We describe the case of a 64-year-old female with an adenocarcinoma of the stomach that was initially treated with a Billroth II gastrectomy, adjuvant chemotherapy and radiotherapy. During follow-up, the diagnosis of peritoneal carcinomatosis was made, and the patient was referred for CRS and HIPEC. Postoperatively, she developed rhabdomyolysis in both gastrocnemius muscles. Renal function remained within normal limits, but ultrasonography of the lower legs suggested the presence of bilateral abscesses. Drainage with pigtail catheters was necessary for more than 1 month, significantly impairing quality of life. The objective of this case report is to heighten awareness for this complication. Rhabdomyolysis is a rare complication of CRS and HIPEC, with a significant impact on quality of life. Prevention is necessary and can be achieved by adequate surgical positioning, using the altered lithotomy position, sufficient padding and by preventing hypovolemia.

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Quality of life after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for peritoneal surface malignancies

Cited by 38 publications

References 35 publications

Quality of Life in Peritoneal Carcinomatosis: A Prospective Study in Patients Undergoing Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy (HIPEC)

Quality of Life in Peritoneal Carcinomatosis: A Prospective Study in Patients Undergoing Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy (HIPEC)

Extensive Cytoreductive Surgery for Appendiceal Carcinomatosis: Morbidity, Mortality, and Survival

Rhabdomyolysis after Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy: A Case Report

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