Annals of Surgical Oncology

, Volume 20, Issue 1, pp 226–232 | Cite as

Quality of Life in Patients after Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy: Is It Worth the Risk?

  • Nikolaos TsilimparisEmail author
  • Christina Bockelmann
  • Wieland Raue
  • Charalambos Menenakos
  • Sebastian Perez
  • Beate Rau
  • Jens Hartmann
Gastrointestinal Oncology



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).


Prospective, single-center, nonrandomized cohort study using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire.


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.


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.


Peritoneal Carcinomatosis Pseudomyxoma Peritonei Hyperthermic Intraperitoneal Chemotherapy Peritoneal Mesothelioma Peritoneal Carcinomatosis Index 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



We thank Dr. Martin Holzhausen from the Institute for Biometrics and Clinical Epidemiology, Charite Universitätsmedizin Berlin for his support on statistical issues and contribution to this paper.


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Copyright information

© Society of Surgical Oncology 2012

Authors and Affiliations

  • Nikolaos Tsilimparis
    • 1
    Email author
  • Christina Bockelmann
    • 1
  • Wieland Raue
    • 1
  • Charalambos Menenakos
    • 1
  • Sebastian Perez
    • 2
  • Beate Rau
    • 1
  • Jens Hartmann
    • 1
  1. 1.Klinik für Allgemein-, Visceral-, Gefäss- und ThoraxchirurgieCharite Universitätsmedizin BerlinBerlinGermany
  2. 2.Emory University School of Medicine, BiostatisticsAtlantaUSA

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