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Effect of Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy on Quality of Life in Patients with Peritoneal Mesothelioma

Annals of Surgical Oncology volume 27, pages 117–123 (2020)Cite this article

Abstract

Introduction

Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC) is an accepted treatment for peritoneal mesothelioma. In this study, we evaluated QOL after HIPEC for peritoneal mesothelioma.

Methods

This was a prospective study performed after HIPEC for peritoneal mesothelioma between 2002 and 2015. Patients completed QOL surveys, including the Short Form-36 (SF-36), Functional Assessment of Cancer Therapy + Colon (FACT-C), Brief Pain Inventory (BPI), and Center for Epidemiologic Studies Depression Scale (CES-D) preoperatively and at 3, 6, 12, and 24 months postoperatively.

Results

Overall, 46 patients underwent HIPEC for peritoneal mesothelioma and completed QOL surveys. Mean age was 52.8 ± 13.8 years and 52% were male. Good preoperative functional status was 70%. Median survival was 3.4 years, and 1, 3, and 5-year survivals were 77.4, 55.2, and 36.5%, respectively. CES-D score decreased at 3 months postoperatively, but increased at 24 months (p = 0.014); SF-36 physical functioning scale decreased at 3 months but returned to baseline at 12 months (p = 0.0045); and the general health scale decreased at 3 months, then improved by 6 months (p = 0.0034). Emotional well-being (p = 0.0051), role limitations due to emotional problems (p = 0.0006), social functioning (p = 0.0022), BPI (p = 0.025), least pain (p = 0.045), and worst pain (p < 0.0001) improved. FACT-C physical well-being decreased at 3 months but returned to baseline at 6 months (p = 0.020), and total FACT-C score improved at 6 months (p = 0.052).

Conclusion

QOL returned to baseline or improved from baseline between 3 months and 1 year following surgery. Despite the risks associated with this operation, patients may tolerate HIPEC well and have good overall QOL postoperatively.

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Funding

Supported in part by the Orin Smith Family fund.

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Authors and Affiliations

  1. Surgical Oncology Service, Department of General Surgery, Wake Forest University, Winston-Salem, NC, USA

    Yasmin M. Ali MD, Joseph Sweeney MD, Perry Shen MD, Konstantinos I. Votanopoulos MD, PhD, Richard McQuellon PhD, Katie Duckworth PhD, Kathleen C. Perry MS, Greg Russell MS & Edward A. Levine MD

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  1. Yasmin M. Ali MD
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  2. Joseph Sweeney MD
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  3. Perry Shen MD
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  4. Konstantinos I. Votanopoulos MD, PhD
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  5. Richard McQuellon PhD
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  6. Katie Duckworth PhD
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  7. Kathleen C. Perry MS
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  9. Edward A. Levine MD
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Correspondence to Edward A. Levine MD.

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Ali, Y.M., Sweeney, J., Shen, P. et al. Effect of Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy on Quality of Life in Patients with Peritoneal Mesothelioma. Ann Surg Oncol 27, 117–123 (2020). https://doi.org/10.1245/s10434-019-07425-5

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  • DOI: https://doi.org/10.1245/s10434-019-07425-5