Perioperative morbidity and quality of life in long-term survivors following cytoreductive surgery and hyperthermic intraperitoneal chemotherapy.
BACKGROUND
Improved prognosis can be achieved in selected patients with peritoneal carcinomatosis (PC) by major surgery and hyperthermic intraperitoneal chemotherapy (HIPEC).


METHODS
Sixty seven patients with PC were operated with the aim of complete macroscopical cytoreduction followed by HIPEC (using cisplatin, mitomycin or mitoxantrone). Quality of life was assessed with the EORTC QLQ-C30 questionnaire.


RESULTS
The patients had a variety of primary tumours, including appendix carcinomas (22/67). Mean operating time was 7 hours and complete cytoreduction was achieved in 58% of the patients. Overall morbidity was 34%. Post-operative mortality was 4.5%. The mean score for global health status of long-term survivors (20 questionnaires/25 patients) was 62.6 (73.3 for the control population, p=0.07). Functional status, particularly the role (56.4) and the social functioning (53.9) were impaired.


CONCLUSIONS
Cytoreductive surgery combined with HIPEC is associated with an increased morbidity and mortality. Complications are predominantly related to major surgery. Following this aggressive treatment, survivors may achieve a satisfactory quality of life.
Schmidt
U
U
Department for Visceral and Transplant Surgery, Medical School of Hannover, D-30623 Hannover, Germany.
Dahlke
M H
MH
Klempnauer
J
J
Schlitt
H J
HJ
Piso
P
P
D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D002945:Cisplatin / Q000627:therapeutic use; D003131:Combined Modality Therapy; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000627:therapeutic use; D008942:Mitoxantrone / Q000627:therapeutic use; D010534:Peritoneal Neoplasms / Q000188:drug therapy / Q000601:surgery*; D011183:Postoperative Complications; D011379:Prognosis; D011788:Quality of Life; D011795:Surveys and Questionnaires
D000970:Antineoplastic Agents; D016685:Mitomycin; D008942:Mitoxantrone; D002945:Cisplatin