Survival and Health Outcomes After Cytoreductive Surgery With Intraperitoneal Hyperthermic Chemotherapy for Disseminated Peritoneal Cancer of Appendiceal Origin
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Cytoreductive surgery with intraperitoneal hyperthermic chemotherapy for peritoneal carcinomatosis of appendiceal origin can alleviate symptoms and prolong survival. This aggressive therapy may impair patient quality of life (QOL). The purpose of this study was to monitor health outcomes before and after treatment.
Patients underwent cytoreductive surgery and intraperitoneal hyperthermic chemotherapy for peritoneal cancer. Patients completed questionnaires consisting of demographic information and the Functional Assessment of Cancer Therapy, the SF-36 Medical Outcomes Study survey, the Center for Epidemiologic Studies—Depression Scale, and the ECOG Performance Status Rating before (T1) and after surgery at 3 (T2), 6 (T3), 12 (T4), and 24 (T5) months. Time trends were assessed with the mixed model (SAS PROC MIXED) to allow use of all the observed data as well as to account for missing data.
Fifty-eight patients (50% female) with a mean age 52.4 years (SD 12.6; range, 28–80) were assessed before surgery. Overall survival at 1 year was 78.7%. Emotional well-being improved over the study period, while physical well-being and physical functioning declined at T2 and then improved to near baseline levels at T3 and T4. Percentage of patients with depressive symptoms was as follows: T1 = 24%, T2 = 30%, T3 = 24%, and T4 = 33%. QOL scores improved over time.
Although complications can affect short-term recovery, survival in appendix cancer patients with peritoneal cancer is good and for some can be achieved without major decrements in QOL at 1 year. Depressive symptoms and some physical limitations remain in surviving patients.
KeywordsHealth outcomes Intraperitoneal hyperthermic chemotherapy
We acknowledge the assistance of Lisa Pruitt, RN, Joyce Fenstermaker, RN, Sheila Lee, and Mary Cromer, and we acknowledge the courage and thoughtfulness of the patients and family members who participated in this study.
- 6.Alexander R, Mavroukakis S, Libutti S, et al. Impact of tumor resection (Rxn) and intraperitoneal (IP) chemotherapy (CHRx) on health related quality of life (HRQL) in patients (Pts) with peritoneal surface malignancies (PSM). Proc Soc Surg Oncol 2005;S109Google Scholar
- 10.Eton D, Fairclough D, Cella D, Yount S, Bonomi P, Johnson D. Early change in patient-reported health during lung cancer chemotherapy predicts clinical outcomes beyond those predicted by baseline report: results from Eastern Cooperative Oncology Group Study 5592. J Clin Oncol 2003;21:1536–43PubMedCrossRefGoogle Scholar
- 14.Ware JE Jr, Snow KK, Kosinski M, Gandek B. SF-36 health survey. In: Manual and Interpretation Guide. Boston: Nimrod Press, 1993Google Scholar
- 22.Sloan J, Cella D, Frost M, Guyatt G, Sprangers M, Symonds T, and the Clinical Significance Consensus. Assessing clinical significance in measuring oncology patient quality of life: introduction to the symposium, content overview, and definition of terms. Mayo Clin Proc 2002;77:367–70PubMedCrossRefGoogle Scholar
- 23.Yost K, Eton D, Cella D, Ayanian J, Zaslavsky A, West D. Minimal important differences on the Functional Assessment of Cancer Therapy—Colorectal. Qual Life Res 2002;11:629Google Scholar
- 34.Alexander R, Mavroukakis S, Libutti S, et al. Impact of tumor resection (Rxn) and intraperitoneal (IP) chemotherapy (CHRx) on health related quality of life (HRQL) in patients (Pts) with peritoneal surface malignancies (PSM). Proc Soc Surg Oncol 2005;S109Google Scholar