Quality of life and symptom distress after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy

Ya-Fen Wang; Ting-Yao Wang; Tzu-Ting Liao; Meng-Hung Lin; Tzu-Hao Huang; Meng-Chiao Hsieh; Vincent Chin-Hung Chen; Li-Wen Lee; Wen-Shih Huang; Chao-Yu Chen

doi:10.12998/wjcc.v10.i32.11775

Quality of life and symptom distress after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy

World J Clin Cases. 2022 Nov 16;10(32):11775-11788. doi: 10.12998/wjcc.v10.i32.11775.

Authors

Ya-Fen Wang¹, Ting-Yao Wang², Tzu-Ting Liao³, Meng-Hung Lin⁴, Tzu-Hao Huang⁵, Meng-Chiao Hsieh⁶, Vincent Chin-Hung Chen⁷, Li-Wen Lee⁸, Wen-Shih Huang⁶, Chao-Yu Chen^{9

10}

Affiliations

¹ Cancer Center, Chang Gung Memorial Hospital, Chiayi, Taiwan.
² Division of Hematology and Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan.
³ Division of Case Management, Cancer Center, Chang Gung Memorial Hospital, Chiayi, Taiwan.
⁴ Health Information and Epidemiology Laboratory, Chang Gung Memorial Hospital, Chiayi, Taiwan.
⁵ Division of General Surgery, Department of Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan.
⁶ Division of Colorectal Surgery, Department of Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan.
⁷ Department of Psychiatry, Chang Gung Memorial Hospital, Chiayi and Chang Gung University, Taoyuan, Taiwan.
⁸ Department of Diagnostic Radiology, Chang Gung Memorial Hospital, Chiayi, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan.
⁹ Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Chiayi, Taiwan.
¹⁰ Department of Early Childhood Care and Education, Shu-Zen Junior College of Medicine and Management, Kaohsiung, Taiwan; Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Chiayi, Taiwan. b9002031@cgmh.org.tw.

Abstract

Background: Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS/ HIPEC) for peritoneal surface malignancy can effectively control the disease, however it is also associated with adverse effects which may affect quality of life (QoL).

Aim: To investigate early perioperative QoL after CRS/HIPEC, which has not been discussed in Taiwan.

Methods: This single institution, observational cohort study enrolled patients who received CRS/HIPEC. We assessed QoL using the Taiwanese version of the MD Anderson Symptom Inventory (MDASI-T) and European Organization Research and Treatment of Cancer Core Quality of Life Questionnaire (EORTC QLQ-C30). Participants completed the questionnaires before CRS/HIPEC (S1), at the first outpatient follow-up (S2), and 3 mo after CRS/HIPEC (S3).

Results: Fifty-eight patients were analyzed. There was no significant perioperative difference in global health status. Significant changes in physical and role functioning scores decreased at S2, and fatigue and pain scores increased at S2 but returned to baseline at S3. Multiple regression analysis showed that age and performance status were significantly correlated with QoL. In the MDASI-T questionnaire, distress/feeling upset and lack of appetite had the highest scores at S1, compared to fatigue and distress/feeling upset at S2, and fatigue and lack of appetite at S3. The leading interference items were working at S1 and S2 and activity at S3. MDASI-T scores were significantly negatively correlated with the EORTC QLQ-C30 results.

Conclusion: QoL and symptom severity improved or returned to baseline in most categories within 3 mo after CRS/HIPEC. Our findings can help with preoperative consultation and perioperative care.

Keywords: Cytoreductive surgery; Hyperthermic intraperitoneal chemotherapy; Perioperative care; Peritoneal carcinomatosis; Quality of life; Symptom distress.