N. M. Hinkle1, V. Botta2, J. P. Sharpe1, P. V. Dickson1, J. Deneve1, G. M. Munene1 1Univeristy Of Tennessee Health Science Center,Surgery,Memphis, TN, USA 2Univeristy Of Tennessee Health Science Center,Medicine,Memphis, TN, USA
Introduction: Improved oncological outcomes following cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS/HIPEC) in highly selected patients have been well documented. The extensive nature of the procedure adversely affects quality of life (QoL). The aim of this study is to longitudinally evaluate QoL following CRS/HIPEC.
Methods: This is a retrospective review of a prospectively maintained database of patients with peritoneal malignancies undergoing CRS/HIPEC. Clinicopathological data, oncologic outcomes, and QoL were analyzed preoperatively and postoperatively at two weeks, one, three, six and twelve months. The FACT-C instrument was utilized to determine changes in QoL following CRS/HIPEC and the impact of early recurrence (<12months) on QoL.
Results:Thirty-six patients underwent CRS/HIPEC over 36 months. The median PCI score was 18 and the CC0/1 rate was 97.2%. Postoperative major morbidity was 16.7% with one perioperative death. Disease-free survival was 12.6 months in patients with high-grade tumors versus 31.0 months in those with low-grade tumors (p=0.03). QoL decreased postoperatively and improved to baseline in six months. Patients with early recurrence had a decrease in global QoL compared to preoperative QoL at 6 months (p<0.03) and 12 months (p<0.05). This correlation was not found in patients who had not recurred.
Conclusion:Patients who undergo CRS/HIPEC have a decrease in QoL that plateaus in 3-6 months. Early recurrence adversely impacts QoL at 6months and at 12month. This study emphasizes the importance of patient selection for CRS/HIPEC. The expected QoL trajectory in patients at risk for early recurrence must be carefully weighed against the potential oncological benefit of CRS/HIPEC.