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Quality of Life After Cytoreductive Surgery plus Early Intraperitoneal Postoperative Chemotherapy for Pseudomyxoma Peritonei: A Prospective Study

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Diseases of the Colon & Rectum

Purpose

The modern treatment of pseudomyxoma peritonei is cytoreductive surgery plus intraperitoneal chemotherapy resulting in a survival of up to 70 percent after 20 years. The goal of this study was to investigate the impact on quality of life of this very aggressive treatment, which has not been done before.

Methods

Twenty-three prospective patients underwent cytoreductive surgery and early postoperative intraperitoneal chemotherapy for pseudomyxoma peritonei. Patients were followed in clinic 3, 6, 12, 18, and 24 months after surgery and had CT scan of the abdomen every 6 months. Quality of life was prospectively assessed with the generic quality of life instrument Short Form-36 Questionnaire, together with the two symptom-specific instruments—European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30, and Colorectal Cancer Module 38—before surgery and at every postoperative visit.

Results

Complete cytoreduction was achieved in 21 patients. No patients died within 30 days. Seventy percent of patients had one or more complications during or after surgery, but all had recovered. Fourteen percent had an asymptomatic recurrence detected within two years. The impact on quality of life of the disease and of its treatment was very modest despite the high morbidity after the treatment. There was a significant decrease in the scores on the Short Form-36 Questionnaire scales of physical dimension and role physical three months after surgery, only returning to normal after another three months. The other scores corresponded to the scores in a normal population.

Conclusions

Cytoreductive surgery plus early postoperative intraperitoneal chemotherapy is an extensive treatment with a high morbidity but with relatively little impact on quality of life in patients with pseudomyxoma peritonei.

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Acknowledgments

The authors thank Gitte Bøje for supervising all the patients completing the questionnaires and Line Buhl, Department of Pathology, Aarhus University Hospital, for meticulous work in histopathologic assessment.

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Authors and Affiliations

  1. Department of Surgery, Nordsjaellands Hospital Hillerod, Hillerod, DK-3400, Denmark

    Per Jess Dr.Med.Sci.

  2. Department of Surgery P, Aarhus University Hospital, Aarhus, Denmark

    Lene H. Iversen Ph.D., Mette B. Nielsen M.D., Søren Laurberg Dr.Med.Sci. & Peter C. Rasmussen M.D.

  3. Department of Oncology, Aarhus University Hospital, Aarhus, Denmark

    Flemming Hansen M.D.

Authors
  1. Per Jess Dr.Med.Sci.
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  2. Lene H. Iversen Ph.D.
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  3. Mette B. Nielsen M.D.
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  4. Flemming Hansen M.D.
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  5. Søren Laurberg Dr.Med.Sci.
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  6. Peter C. Rasmussen M.D.
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Corresponding author

Correspondence to Per Jess Dr.Med.Sci..

Additional information

Supported in part by Den Regionale Forskningsfond for Region Midtjylland og Nordjylland.

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Jess, P., Iversen, L.H., Nielsen, M.B. et al. Quality of Life After Cytoreductive Surgery plus Early Intraperitoneal Postoperative Chemotherapy for Pseudomyxoma Peritonei: A Prospective Study. Dis Colon Rectum 51, 868–874 (2008). https://doi.org/10.1007/s10350-008-9223-6

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  • DOI: https://doi.org/10.1007/s10350-008-9223-6

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