Can Baseline Quality of Life Scores Predict for Morbidity and Survival After CRS and HIPEC: a Prospective Study of 151 Patients

Overview

Journal Pleura Peritoneum

Date 2022 Jul 11

PMID 35812011

Authors

Claramae Shulyn Chia

Chin-Ann Johnny Ong

Hong-Yuan Zhu

Cindy Lim

Jolene Si Min Wong

Grace Hwei Ching Tan

Melissa Ching Ching Teo

Affiliations

Soon will be listed here.

Abstract

Objectives: Various studies have shown that good quality of life (QoL) can be achieved after cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC). There is prognostic value of baseline QoL in post-operative outcome in Western setting. Our prospective study aims to validate these observations and elucidate clinical factors that predict poorer QoL in Asian peritoneal carcinomatosis patients.

Methods: European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire was administered to patients before CRS and HIPEC and thereafter at 3, 6 and 12 months.

Results: A total of 151 patients underwent 155 surgeries. Four hundred and seventy two questionnaires were completed. Median disease-free survival (DFS) was 16.5 months. Three year DFS and overall survival (OS) were 24.0% and 73.0% respectively. Post-operative global health status significantly increased at 3, 6 and 12 months. The decreases in functional scales recovered to baseline by 1-year post-surgery. Peritoneal carcinomatosis index (PCI), presence of stoma, peritonectomy duration, death within one year, post-operative complication and length of SICU stay negatively influenced QoL. Complication rates were higher in patients with lower global health status, physical and role functioning scores and higher symptom summary scores at baseline. Lower social functioning score, and higher pain, dyspnoea and symptom summary scores at baseline were significantly associated with poorer OS.

Conclusions: Various clinical factors can help us predict a patient's QoL after surgery. Several baseline factors were also able to predict morbidity and survival. Going forward, we can use these factors to help us better select patients who will have a greater benefit from CRS and HIPEC.

References

Schmidt U, Dahlke M, Klempnauer J, Schlitt H, Piso P . Perioperative morbidity and quality of life in long-term survivors following cytoreductive surgery and hyperthermic intraperitoneal chemotherapy. Eur J Surg Oncol. 2005; 31(1):53-8. DOI: 10.1016/j.ejso.2004.09.011. View

Anthony T, Hynan L, Rosen D, Kim L, Nwariaku F, Jones C . The association of pretreatment health-related quality of life with surgical complications for patients undergoing open surgical resection for colorectal cancer. Ann Surg. 2003; 238(5):690-6. PMC: 1356147. DOI: 10.1097/01.sla.0000094304.17672.6e. View

Ihemelandu C, McQuellon R, Shen P, Stewart J, Votanopoulos K, Levine E . Predicting postoperative morbidity following cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CS+HIPEC) with preoperative FACT-C (Functional Assessment of Cancer Therapy) and patient-rated performance status. Ann Surg Oncol. 2013; 20(11):3519-26. DOI: 10.1245/s10434-013-3049-8. View

Mierzynska J, Piccinin C, Pe M, Martinelli F, Gotay C, Coens C . Prognostic value of patient-reported outcomes from international randomised clinical trials on cancer: a systematic review. Lancet Oncol. 2019; 20(12):e685-e698. DOI: 10.1016/S1470-2045(19)30656-4. View

Teo M, Tan G, Tham C, Lim C, Soo K . Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in Asian patients: 100 consecutive patients in a single institution. Ann Surg Oncol. 2013; 20(9):2968-74. DOI: 10.1245/s10434-013-2947-0. View

Dodson R, McQuellon R, Mogal H, Duckworth K, Russell G, Votanopoulos K . Quality-of-Life Evaluation After Cytoreductive Surgery with Hyperthermic Intraperitoneal Chemotherapy. Ann Surg Oncol. 2016; 23(Suppl 5):772-783. PMC: 5391836. DOI: 10.1245/s10434-016-5547-y. View

Hinz A, Einenkel J, Briest S, Stolzenburg J, Papsdorf K, Singer S . Is it useful to calculate sum scores of the quality of life questionnaire EORTC QLQ-C30?. Eur J Cancer Care (Engl). 2012; 21(5):677-83. DOI: 10.1111/j.1365-2354.2012.01367.x. View

Passot G, Bakrin N, Roux A, Vaudoyer D, Gilly F, Glehen O . Quality of life after cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy: a prospective study of 216 patients. Eur J Surg Oncol. 2013; 40(5):529-535. DOI: 10.1016/j.ejso.2013.11.019. View

McQuellon R, Loggie B, Fleming R, Russell G, Lehman A, Rambo T . Quality of life after intraperitoneal hyperthermic chemotherapy (IPHC) for peritoneal carcinomatosis. Eur J Surg Oncol. 2001; 27(1):65-73. DOI: 10.1053/ejso.2000.1033. View

10.

McQuellon R, Danhauer S, Russell G, Shen P, Fenstermaker J, Stewart J . Monitoring health outcomes following cytoreductive surgery plus intraperitoneal hyperthermic chemotherapy for peritoneal carcinomatosis. Ann Surg Oncol. 2007; 14(3):1105-13. DOI: 10.1245/s10434-006-9304-5. View

11.

Tan W, Wong J, Chia C, Tan G, Soo K, Teo M . Quality of life after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy: an Asian perspective. Ann Surg Oncol. 2013; 20(13):4219-23. DOI: 10.1245/s10434-013-3133-0. View

12.

Leimkuhler M, Hentzen J, Hemmer P, Been L, van Ginkel R, Kruijff S . Systematic Review of Factors Affecting Quality of Life After Cytoreductive Surgery with Hyperthermic Intraperitoneal Chemotherapy. Ann Surg Oncol. 2020; 27(10):3973-3983. PMC: 7471142. DOI: 10.1245/s10434-020-08379-9. View

13.

Tuttle T, Zhang Y, Greeno E, Knutsen A . Toxicity and quality of life after cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy. Ann Surg Oncol. 2006; 13(12):1627-32. DOI: 10.1245/s10434-006-9186-6. View

14.

Chua T, Yan T, Saxena A, Morris D . Should the treatment of peritoneal carcinomatosis by cytoreductive surgery and hyperthermic intraperitoneal chemotherapy still be regarded as a highly morbid procedure?: a systematic review of morbidity and mortality. Ann Surg. 2009; 249(6):900-7. DOI: 10.1097/SLA.0b013e3181a45d86. View

15.

Chia C, Tan G, Lim C, Soo K, Teo M . Prospective Quality of Life Study for Colorectal Cancer Patients with Peritoneal Carcinomatosis Undergoing Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy. Ann Surg Oncol. 2016; 23(9):2905-13. DOI: 10.1245/s10434-016-5203-6. View

16.

Chia C, Tan W, Wong J, Tan G, Lim C, Wang W . Quality of life in patients with peritoneal surface malignancies after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy. Eur J Surg Oncol. 2014; 40(8):909-16. DOI: 10.1016/j.ejso.2013.12.028. View

17.

Saxton A, Velanovich V . Preoperative frailty and quality of life as predictors of postoperative complications. Ann Surg. 2011; 253(6):1223-9. DOI: 10.1097/SLA.0b013e318214bce7. View

18.

Uwer L, Rotonda C, Guillemin F, Miny J, Kaminsky M, Mercier M . Responsiveness of EORTC QLQ-C30, QLQ-CR38 and FACT-C quality of life questionnaires in patients with colorectal cancer. Health Qual Life Outcomes. 2011; 9:70. PMC: 3170175. DOI: 10.1186/1477-7525-9-70. View

19.

McQuellon R, Loggie B, Lehman A, Russell G, Fleming R, Shen P . Long-term survivorship and quality of life after cytoreductive surgery plus intraperitoneal hyperthermic chemotherapy for peritoneal carcinomatosis. Ann Surg Oncol. 2003; 10(2):155-62. DOI: 10.1245/aso.2003.03.067. View