Health-Related Quality of Life After Cytoreductive Surgery/HIPEC for Mucinous Appendiceal Cancer: Results of a Multicenter Randomized Trial Comparing Oxaliplatin and Mitomycin

Overview

Journal Ann Surg Oncol

Publisher Springer

Specialty Oncology

Date 2019 Nov 14

PMID 31720933

Citations 16

Authors

Omeed Moaven

Konstantinos I Votanopoulos

Perry Shen

Paul Mansfield

David L Bartlett

Greg Russell

Richard McQuellon

John H Stewart

Edward A Levine

Affiliations

Soon will be listed here.

Abstract

Background: This study evaluated health-related quality of life (HRQOL) using patient-reported outcomes in subjects with mucinous appendiceal neoplasms who underwent cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) as part of a randomized trial comparing mitomycin with oxaliplatin.

Methods: In this prospective multicenter study, 121 mucinous appendiceal cancer patients, with evidence of peritoneal dissemination who underwent CRS, were randomized to receive mitomycin (divided 40 mg) or oxaliplatin (200 mg/m) for HIPEC. The Functional Assessment of Cancer Therapy Neurotoxicity (FACT-G/NTX) questionnaire was utilized to assess HRQOL. The Trial Outcome Index (TOI) is a summary index responsive to changes in physical/functional outcomes. Repeated measures mixed models with an unstructured variance matrix were applied to assess changes in HRQOL longitudinally.

Results: Baseline questionnaire compliance was 95.9%. Baseline physical well-being (PWB) was independently associated with overall survival (hazard ratio 0.79, 95% confidence interval 0.66-0.96; p = 0.017). The TOI was significantly lower in the mitomycin group compared with the oxaliplatin arm at 12 weeks (p = 0.044; score difference 6.35) and 24 weeks after surgery (p = 0.049; score difference 5.61). At 12 weeks after surgery, declines from baseline were significant in the TOI (p = 0.004; score decline 8.99), PWB (p < 0.001; score decline 2.83), and FWB (p < 0.001; score decline 3.42) in the mitomycin group but not the oxaliplatin group.

Conclusions: Compared with mitomycin, HIPEC perfusion with oxaliplatin results in significantly better physical and functional outcomes. With similar survival outcomes and complication rates, oxaliplatin should be considered as the chemoperfusion agent of choice in mucinous appendiceal cancer patients undergoing CRS/HIPEC.

Citing Articles

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Holowatyj A, Overman M, Votanopoulos K, Lowy A, Wagner P, Washington M Nat Rev Cancer. 2025; .

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Invited Commentary: Ten-Year Outcome of a Randomized Trial: Cytoreduction and HIPEC with Mitomycin C Versus Oxaliplatin for Appendiceal Neoplasm with Peritoneal Dissemination, by Levine et al.

Alexander H Ann Surg Oncol. 2024; 32(3):1420-1421.

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Sleiman M, Jelip A, Buchs N, Toso C, Liot E, Koessler T Cancers (Basel). 2024; 16(21).

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Exploring the Patient Experience Through Qualitative Methods: The Missing Piece of Cytoreductive Surgery and HIPEC Research.

Ward E, Greenbaum A Ann Surg Oncol. 2024; 31(12):7679-7681.

PMID: 39103683 DOI: 10.1245/s10434-024-15997-0.

The 2022 PSOGI International Consensus on HIPEC Regimens for Peritoneal Malignancies: Pseudomyxoma Peritonei.

Kusamura S, Delhorme J, Taibi A, Villeneuve L, Deraco M, Dico R Ann Surg Oncol. 2024; 31(9):6262-6273.

PMID: 39008204 DOI: 10.1245/s10434-024-15646-6.

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