Quality of life after cytoreductive surgery and hyperthermic intra-peritoneal chemotherapy for peritoneal carcinomatosis: A systematic review and meta-analysis

Shan, Leonard; Saxena, Akshat; Shan, Bernard L.; Morris, David L.

doi:10.1016/j.suronc.2014.10.002

Cited by 39 publications

(33 citation statements)

References 36 publications

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“…However, at 6-12 months after the procedure, health-related quality of life improves from its preoperative level. At 1 year after crs and hipec (compared with the preoperative assessment), postoperative scores on the Functional Assessment of Cancer Therapy and the European Organisation for Research and Treatment of Cancer quality-of-life questionnaire were significantly improved for overall health status (p = 0.001) and emotional health (p = 0.001); physical health (p = 0.83), social health (p = 0.48), and functional health (p = 0.24) remained similar 100 . The indicated benefits can persist for up to 5 years.…”

Section: Morbidity Related To Crs and Hipec And Quality Of Lifementioning

confidence: 91%

Treatment of Peritoneal Surface Malignancies with Hyperthermic Intraperitoneal Chemotherapy—Current Perspectives

2016

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Peritoneal carcinomatosis (ptc) represents advanced malignant disease and has generally been associated with a grim prognosis. Peritoneal surface malignancy is often the major source of morbidity and mortality; it is of major concern in cancer management. Although ptc is categorized as metastatic disease, it represents a special disease pattern considered to be a locoregional disease limited to the abdominal cavity. The combination of cytoreductive surgery (crs) and intraoperative hyperthermic intraperitoneal chemotherapy (hipec) has successfully been used as locoregional treatment for selected patients with ptc from gastric, colorectal, and ovarian cancer; with mesothelioma; and with pseudomyxoma peritonei. In the prophylactic setting, hipec can also be used to prevent ptc in high-risk patients, and the first results of the "second-look" approach are promising. Patient selection-in which the risks of perioperative morbidity and mortality, which are analogous to those for any other major gastrointestinal surgery, are assessed-is of utmost importance. Those risks have to be weighed against the anticipated survival benefit, which depends mainly on tumour biology, extent of disease, and probability of achieving complete crs. The present review discusses the principles of crs and hipec, the most significant recent clinical data, and current perspectives concerning the application of this treatment modality in various malignancies. Ongoing trials and future directions are noted. It appears that the combination of crs and hipec is an indispensable tool in the oncologist's armamentarium.

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Section: Morbidity Related To Crs and Hipec And Quality Of Lifementioning

confidence: 91%

Treatment of Peritoneal Surface Malignancies with Hyperthermic Intraperitoneal Chemotherapy—Current Perspectives

2016

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“…In literature, published systematic reviews regarding QoL after CRS/HIPEC concluded that patients, after experiencing a significant decrease in QoL, usually return to baseline QoL levels within 12 months after surgery. 3,4 However, a high proportion of patients lost to follow-up in these studies probably led to underrepresentation of the most frail patients in these cohorts. Also, most of these reviews rely on limited literature searches, seldomly reporting a wide range of QoL domains.…”

Section: Presentmentioning

confidence: 98%

ASO Author Reflections: A Systematic Review of Factors Affecting Quality of Life After Cytoreductive Surgery with Hyperthermic Intraperitoneal Chemotherapy

Leeuwen

Kruijff

2020

Ann Surg Oncol

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Only 3 decades ago, patients with peritoneal metastasis, either metachronous or synchronous, were considered incurable and suitable only for palliative treatment. Back then, if left untreated, peritoneal metastasized patients had poor prognosis, high morbidity, and reduced quality of life (QoL). 1 Fortunately, a curative-intent treatment option arose: cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC). This suddenly gave patients with resectable peritoneal metastasis (PM) the option of undergoing a potentially curative treatment. CRS/HIPEC combines surgical removal of all macroscopically visible disease with perfusion of the abdominal cavity with heated chemotherapy to eradicate residual microscopic disease. After its introduction, cumulative scientific evidence seemed to illustrate improved survival outcomes when compared with systemic chemotherapy alone. 2 If selected carefully, e.g., without distant metastases, aggressive CRS/HIPEC seemed to be a potentially curative treatment for 30-40% of patients. Unfortunately, today, this invasive procedure is still accompanied by a high treatment-related mortality of 0-8%, a grade 3-4 morbidity of 18-52%, and a negative impact on QoL of patients up to 1 year after. 3 Since the majority of patients undergoing CRS/HIPEC will not be cured by this procedure, the high morbidity rates are an ongoing concern.

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“…A retrospective analysis of 78 patients undergoing CRS and HIPEC demonstrated a large intraoperative fluid turnover, increased airway pressure, and central venous pressure (due to the increased intra-abdominal pressure with the closed technique), while increased body temperature resulted in a mild metabolic acidosis (88). According to the findings of another prospective study of 60 patients, hemodynamic disturbances occurred during HIPEC administration, characterized by an increase in heart rate and cardiac output and a decreased systemic vascular resistance on account of increased body temperature and decreased effective circulating volume (89,90).…”

Section: Hemodynamic Parameters and Related Morbiditymentioning

confidence: 99%

“…Recent systematic reviews (91,92) and a meta-analysis (90) of fifteen studies (1,583 patients), demonstrated that healthrelated quality of life declines immediately after. However, at 6-12 months after the procedure, health-related quality of life improves from its preoperative level.…”

Section: Post-operative Quality Of Healthmentioning

confidence: 99%

A critical analysis of the cytoreductive surgery with hyperthermic intraperitoneal chemotherapy combo in the clinical management of advanced gastric cancer: an effective multimodality approach with scope for improvement

Beeharry

Yao

et al. 2016

Transl. Gastroenterol. Hepatol.

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Peritoneal carcinomatosis (PC) is manifested in up to 40% of gastric cancer (GC) patients, after which their 5-year survival drops to less than 5%. The currently most acceptable treatment option for advanced GC (AGC) is systemic chemo and radio therapies with however generally very unsatisfying results and this led to a resurgence of interest in regional therapies like cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC). Small trials have indicated an association with prolonged survival when applying this technique to AGC manifesting with PC. High procedure-related morbidity and mortality associated with the CRS-HIPEC approach have however brought by a polemic on the merits of the latter: with the advent of regulatory approval of more effective as well as novel, more personalized treatment options in AGC, along with advances in tailoring investigational agents specifically for peritoneal delivery, there clearly is a need to outline the appropriate role of CRS-HIPEC in this disease.In a clear objective to improve the therapeutic efficiency of HIPEC, there have been immense developments in the technical aspects of this technology including the use of nanotechnology in more precise drug delivery systems (DDS) or choice of more efficient drugs such as gene-target technology, laparoscopy and so on. Henceforth, in this review, we will be highlighting the past and current status of the CRS + HIPEC procedure, shedding light on the pros and cons in order to boost up the efficiency of this multimodality approach.

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Quality of life after cytoreductive surgery and hyperthermic intra-peritoneal chemotherapy for peritoneal carcinomatosis: A systematic review and meta-analysis

Cited by 39 publications

References 36 publications

Treatment of Peritoneal Surface Malignancies with Hyperthermic Intraperitoneal Chemotherapy—Current Perspectives

Treatment of Peritoneal Surface Malignancies with Hyperthermic Intraperitoneal Chemotherapy—Current Perspectives

ASO Author Reflections: A Systematic Review of Factors Affecting Quality of Life After Cytoreductive Surgery with Hyperthermic Intraperitoneal Chemotherapy

A critical analysis of the cytoreductive surgery with hyperthermic intraperitoneal chemotherapy combo in the clinical management of advanced gastric cancer: an effective multimodality approach with scope for improvement

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