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Monitoring Health Outcomes Following Cytoreductive Surgery Plus Intraperitoneal Hyperthermic Chemotherapy for Peritoneal Carcinomatosis

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Abstract

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.

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ACKNOWLEDGEMENTS

This study was supported in part by the Robert Welborne Fund. The authors gratefully acknowledge the assistance of Tammy Alley, Adrienne Robbins, Daniel Burke and the courage and thoughtfulness of the patients and family members who participated in this study.

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Authors and Affiliations

  1. Department of Internal Medicine, Section of Hematology and Oncology, Wake Forest University, School of Medicine, Winston-Salem, NC, USA

    Richard P. McQuellon & Suzanne C. Danhauer

  2. Department of Biostatistics, Wake Forest University, School of Medicine, Winston-Salem, NC, USA

    Gregory B. Russell

  3. Department of Surgical Oncology, Wake Forest University, School of Medicine, Winston-Salem, NC, USA

    Perry Shen, Joyce Fenstermaker, John H. Stewart & Edward A. Levine

  4. Comprehensive Cancer Center of Wake Forest University, Medical Center Blvd., Winston-Salem, NC, 27157-1082, USA

    Richard P. McQuellon, Suzanne C. Danhauer, Gregory B. Russell, Perry Shen, John H. Stewart & Edward A. Levine

Authors
  1. Richard P. McQuellon
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  2. Suzanne C. Danhauer
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  3. Gregory B. Russell
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  4. Perry Shen
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  5. Joyce Fenstermaker
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Correspondence to Richard P. McQuellon.

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McQuellon, R.P., Danhauer, S.C., Russell, G.B. et al. Monitoring Health Outcomes Following Cytoreductive Surgery Plus Intraperitoneal Hyperthermic Chemotherapy for Peritoneal Carcinomatosis. Ann Surg Oncol 14, 1105–1113 (2007). https://doi.org/10.1245/s10434-006-9304-5

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  • DOI: https://doi.org/10.1245/s10434-006-9304-5

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