Survival and quality of life following cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy for peritoneal carcinomatosis of colonic origin.

Abstract

BACKGROUND:

Peritoneal carcinomatosis of colonic origin (PCC) is a life-threatening diagnosis. Cytoreductive surgery (CS) with hyperthermic intraperitoneal chemotherapy (HIPEC) offers patients the prospect of long-term survival with alleviation of symptoms.

METHODS:

Patients underwent HIPEC for PCC and completed questionnaires preoperatively (T1) and after surgery at 3 (T2), 6 (T3), and 12 (T4) months. Questionnaires included the Functional Assessment of Cancer Therapy-Colon (FACT-C), Brief Pain Inventory (BPI), SF-36 Medical Outcomes Study Survey (SF-36), Center for Epidemiologic Studies-Depression Scale (CES-D), and the ECOG Performance Status Rating.

RESULTS:

A total of 62 patients were assessed before surgery. Median overall survival was 18 months, with 71.3 ± 6.3% survival at 1 year. Emotional well-being (P = .0007) improved after HIPEC. Social/family well-being (P = .065) and the colon subscale (P = .061) of the FACT worsened at T2, but recovered by T3. One-third to one-half of patients reported depressive symptoms over the course of the study. Pain scores increased above BL at T2, but decreased below BL at T3 and T4.

CONCLUSIONS:

Emotional well being is improved after CS + HIPEC despite complications that may affect short-term recovery. Most patients remaining in the study recover to preoperative levels of functioning between 3 and 6 months after surgery. For some, survival can be attained without major decrement in QOL at 1 year. QOL concerns must be a key component in the evaluation for patients with PCC for CS and HIPEC.

• Authors: Adrienne R Hill, Richard P McQuellon, Gregory B Russell, Perry Shen, John H Stewart 4th, Edward A Levine
• Journal: Annals of surgical oncology (Ann Surg Oncol) Vol. 18 Issue 13 Pg. 3673-9 (Dec 2011) ISSN: 1534-4681 [Electronic] United States
• PMID: 21674272 (Publication Type: Journal Article)

Topics

• Activities of Daily Living
• Adult
• Aged
• Aged, 80 and over
• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Carcinoma (mortality, secondary, therapy)
• Chemotherapy, Cancer, Regional Perfusion
• Colonic Neoplasms (mortality, pathology, therapy)
• Combined Modality Therapy
• Female
• Follow-Up Studies
• Humans
• Hyperthermia, Induced
• Injections, Intraperitoneal
• Male
• Middle Aged
• Neoplasm Staging
• Peritoneal Neoplasms (mortality, secondary, therapy)
• Prognosis
• Prospective Studies
• Quality of Life
• Surveys and Questionnaires
• Survival Rate