Monitoring health outcomes following cytoreductive surgery plus intraperitoneal hyperthermic chemotherapy for peritoneal carcinomatosis.
BACKGROUND
Cytoreductive surgery with intraperitoneal hyperthermic chemotherapy for peritoneal carcinomitosis (PC) is an aggressive treatment designed to alleviate symptoms and prolong life. It is associated with physical and psychological morbidity. The purpose of this study was to monitor health outcomes related to treatment.


METHODS
Patients completed a questionnaire before and after surgery at 3, 6 and 12 months. The questionnaire consisted of basic demographic items as well as the Functional Assessment of Cancer Therapy-Colon Scale (FACT-C), SF-36 Medical Outcomes Study Health Survey, Center for Epidemiologic Studies-Depression Scale (CES-D), Brief Pain Inventory-Short Form, and ECOG Performance Status Rating. Time trends were assessed with mixed models (SAS PROC MIXED) so as to use all data and to account for missing data.


RESULTS
Ninety-six patients (49% females, 9% African Americans) of an average age of 52.9 (SD = 12.5) years were assessed before surgery. PC originated in primary lesions of the appendix (n = 36); colon/rectum (n = 24); mesothelium (n = 9); ovary (n = 5); stomach (n = 4); and miscellaneous (n = 18). Quality of life (QOL) and pain scores improved from baseline to 12 months. Physical functioning changed over the 12-month study period with improvement recorded at 6 months. The percentage of patients reporting significant depressive symptom at each time point was; baseline = 32%; 3 months = 19%; 6 & 12 months = 24%.


CONCLUSIONS
Acceptable QOL, return of functional status, and reduced pain can be attained between 3 and 6 months following treatment although some deficits in general health remain. Depressive symptoms are common and should be monitored.
McQuellon
Richard P
RP
Department of Internal Medicine, Section of Hematology and Oncology, Wake Forest University, School of Medicine, Winston-Salem, NC, USA. rmcquell@wfubmc.edu
Danhauer
Suzanne C
SC
Russell
Gregory B
GB
Shen
Perry
P
Fenstermaker
Joyce
J
Stewart
John H
JH
Levine
Edward A
EA
D000203:Activities of Daily Living; D000230:Adenocarcinoma / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage; D010478:Chemotherapy, Cancer, Regional Perfusion; D003131:Combined Modality Therapy; D003863:Depression / Q000209:etiology; D005260:Female; D006304:Health Status; D006801:Humans; D006979:Hyperthermia, Induced; D007432:Intraoperative Period; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage; D010534:Peritoneal Neoplasms / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D011446:Prospective Studies; D011788:Quality of Life; D011795:Surveys and Questionnaires; D015996:Survival Rate; D016896:Treatment Outcome
D000903:Antibiotics, Antineoplastic; D016685:Mitomycin