title: Quality of life in patients after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy: is it worth the risk?
abstract: OBJECTIVE
  To investigate the course of health-related quality of life (HQL) over time in patients with peritoneal carcinomatosis (PC) after complete cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC).
  
  
  METHODS
  Prospective, single-center, nonrandomized cohort study using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire.
  
  
  RESULTS
  Ninety patients who underwent CRS and HIPEC for PC in our institution were enrolled in the study. Mean age was 56 years (range 27-77 years) (61% female). Primary tumor was colorectal in 21%, ovarian in 19%, pseudomyxoma peritonei in 16%, an appendix tumor in 16%, gastric cancer in 10%, and peritoneal mesothelioma in 13% of cases. Mean peritoneal carcinomatosis index was 22 (range 2-39). Mean global health status score was 69±25 preoperatively and 55±20, 66±22, 66±23, 71±23, and 78±21 at months 1, 6, 12, 24, and 36, respectively. Physical and role function recovered significantly at 6 months and were close to baseline at the 24-month measurement. Emotional function starting from a low baseline recovered to baseline by month 12. Cognitive and social function had slow recovery on follow-up. Fatigue, diarrhea, dyspnea, and sleep disturbance were symptoms persistent at 6-month follow-up, improving later on in survivors.
  
  
  CONCLUSIONS
  Survivors after CRS and HIPEC have postoperative quality of life similar to preoperatively, with most of the reduced elements recovering after 6-12 months. We conclude that reduced quality of life of patients after CRS and HIPEC should not be used as an argument to deny surgical therapy to these patients.
authors.affiliation: Klinik für Allgemein-, Visceral-, Gefäss- und Thoraxchirurgie, Charite Universitätsmedizin Berlin, Berlin, Germany. nikolaos.tsilimparis@charite.de
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Tsilimparis
authors.forename: Christina
authors.initials: C
authors.lastname: Bockelmann
authors.forename: Wieland
authors.initials: W
authors.lastname: Raue
authors.forename: Charalambos
authors.initials: C
authors.lastname: Menenakos
authors.forename: Sebastian
authors.initials: S
authors.lastname: Perez
authors.forename: Beate
authors.initials: B
authors.lastname: Rau
authors.forename: Jens
authors.initials: J
authors.lastname: Hartmann
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001063:Appendiceal Neoplasms / Q000473:pathology; D002277:Carcinoma / Q000556:secondary / Q000601:surgery / Q000628:therapy*; D015179:Colorectal Neoplasms / Q000473:pathology; D003131:Combined Modality Therapy / Q000009:adverse effects; D003967:Diarrhea / Q000209:etiology; D004417:Dyspnea / Q000209:etiology; D020920:Dyssomnias / Q000209:etiology; D005221:Fatigue / Q000209:etiology; D005260:Female; D006801:Humans; D006979:Hyperthermia, Induced / Q000009:adverse effects; D008297:Male; D008654:Mesothelioma / Q000601:surgery / Q000628:therapy*; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000473:pathology; D010534:Peritoneal Neoplasms / Q000556:secondary / Q000601:surgery / Q000628:therapy*; D011553:Pseudomyxoma Peritonei / Q000601:surgery / Q000628:therapy*; D011788:Quality of Life; D011795:Surveys and Questionnaires; D013997:Time Factors
chemical_list: D000970:Antineoplastic Agents