Quality of Life in Patients after Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy: Is It Worth the Risk?

Tsilimparis, Nikolaos; Bockelmann, Christina; Raue, W.; Menenakos, Charalambos; Perez, Sebastian D.; Rau, Beate; Hartmann, Jens

doi:10.1245/s10434-012-2579-9

Cited by 63 publications

(57 citation statements)

References 24 publications

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“…A recent prospective study by Tsilimparis et al [21] showed a recovery of health-related quality of life similar to our data. This growing evidence from an increasing number of centers indicates that in this highly specialized field of oncological surgery, good results can be achieved not only in a few leading centers that may be operating in extremely favorable conditions but also in many different institutions and healthcare systems.…”

Section: Discussionsupporting

confidence: 92%

Quality of Life in Peritoneal Carcinomatosis: A Prospective Study in Patients Undergoing Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy (HIPEC)

et al. 2014

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Background/Aims: Cytoreductive surgery and hyperthermic intraperitoneal chemoperfusion (HIPEC) can improve survival in selected patients with peritoneal carcinomatosis, but bear a significant risk of perioperative morbidity. The aim of this study was to prospectively evaluate the quality of life (QoL) following cytoreduction and HIPEC. Methods: In this study including 40 patients (65% females) with different primary tumors, the EORTC QLQ-C30 questionnaire was applied prior to CS and HIPEC as well as 3, 9, and 18 months postoperatively. Results: Global health status was not impaired significantly following HIPEC. Scales and symptom scores that deteriorated 3 months postoperatively (p < 0.05), that is, physical, role, and social functions as well as fatigue, pain, dyspnea, insomnia, and diarrhea, all returned to preoperative values within 9 months. Conclusions: Following cytoreductive surgery and HIPEC, QoL returns to preoperative levels within 9 months. Selected patients that are likely to benefit oncologically from HIPEC should not be denied this option for fear of reduced postoperative QoL. i 2014 S. Karger AG, Basel

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Section: Discussionsupporting

confidence: 92%

Quality of Life in Peritoneal Carcinomatosis: A Prospective Study in Patients Undergoing Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy (HIPEC)

et al. 2014

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“…The surgery is presumed to have a lasting negative impact on the patients quality of life. While there have been no studies that look at patients undergoing CRS and HIPEC for gastric cancer in particular, there have been numerous retrospective and prospective studies that have looked at patients undergoing CRS and HIPEC for various pathologies [69][70][71][72][73][74][75][76]. Various quality of life instruments have been used which include the EORTC and SF 21.…”

Section: Discussionmentioning

confidence: 99%

Survival outcomes after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for peritoneal carcinomatosis from gastric cancer: a systematic review

Chia

Seshadri

Képénékian³

et al. 2016

Pleura and Peritoneum

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Background: The current treatment of choice for peritoneal carcinomatosis from gastric cancer is systemic chemotherapy. Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) is a new aggressive form of loco-regional treatment that is currently being used in pseudomyxoma peritoneii, peritoneal mesothelioma and peritoneal carcinomatosis from colorectal cancer. It is still under investigation for its use in gastric cancer. Methods: The literature between 1970 and 2016 was surveyed systematically through a review of published studies on the treatment outcomes of CRS and HIPEC for peritoneal carcinomatosis from gastric cancer. Results: Seventeen studies were included in this review. The median survival for all patients ranged from 6.6 to 15.8 months. The 5-years overall survival ranged from 6 to 31%. For patients with complete cytoreduction, the median survival was 11.2 to 43.4 months and the 5-years overall survival was 13 % to 23%. Important prognostic factors were found to be a low peritoneal carcarcinomatosis index (PCI) score and the completeness of cytoreduction.

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“…Many cancer treatments prolong life at the cost of significant morbidity; however, there is evidence that CRS-HIPEC may provide both morbidity and mortality benefit. This question of quality of life was also addressed by Tsilimparis et al, 64 they found patient quality of life after CRS-HIPEC to be similar to what it was preoperatively. Moreover, most measures of quality of life recovered to normal levels within 6-12 months of undergoing CRS-HIPEC.…”

mentioning

confidence: 82%

“…66 For many patients with gastric cancer, the palliative benefit and reduction in cancer morbidity with the use of HIPEC is significant. This question of quality of life was also addressed by Tsilimparis et al, 64 they found that patients undergoing CRS-HIPEC had quality of life after surgery similar to what it was preoperatively with most measures of quality of life recovering to normal levels within 6-12 months. They concluded that reduced quality of life was not an argument against denying these patients this beneficial treatment option.…”

mentioning

confidence: 87%

“…Importantly, no patients included in this study had local or systemic infections, wound disruption, or other clinically important adverse events. Some of the more common intraand postoperative complications that were studied included longer duration of surgery, 33 intraoperative blood loss, anastomotic leakage, surgical site infections and intra-abdominal abscesses, 64 re-operation, longer hospital stay, respiratory complications, and chemotherapy or HIPEC-related toxicity. Overall, many of these studies either support CRS-HIPEC for reducing morbidity or find that the morbidity associated with CRS-HIPEC is acceptable given the associated increase in life expectancy.…”

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confidence: 99%

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Current perspectives on hyperthermic intraperitoneal chemotherapy in gastric cancer

Smith¹,

Kirkpatrick²,

Thomas³

et al. 2017

GICTT

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Cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) is an effective treatment in a variety of cancers with peritoneal carcinomatosis (PC), especially in pseudomyxoma peritonei for which it is the standard of care. The data for gastric cancer are not as conclusive. This review discusses the effect of HIPEC on gastric cancer survival, the importance of patient selection, the effect of HIPEC on gastric cancer morbidity, translational research on HIPEC, and other recent research on HIPEC in the setting of gastric cancer and/or peritoneal metastases. CRS-HIPEC has been shown to be superior to either CRS alone or systemic chemotherapy alone in terms of improving survival. CRS-HIPEC seems to be the best current treatment for patients with gastric cancer and peritoneal metastases. The international community has recommended it as the treatment for this disease. Prudent patient selection before CRS-HIPEC is recommended as subgroups of patients have been shown to benefit from the treatment, while others have not. Studies on CRS-HIPEC have shown the procedure to have acceptably low rates of morbidity and peri-and postoperative complications as well as significant reductions in the incidence of ascites associated with PC. Translational research on HIPEC supports its use as prophylaxis for prevention of peritoneal metastasis and demonstrates HIPEC to be both effective and safe. Measurement of the tumor marker carcinoembryonic antigen has been shown to be an effective indicator of future outcomes in gastric cancer treated with CRS-HIPEC. Although the treatment outcomes have improved, even current treatment using CRS-HIPEC for gastric cancer with PC the survival rates can be dismal. Thus, the treatment of advanced gastric cancer with PC is an ongoing field of study and future directions of the treatment of gastric cancer with PC may include the use of intraperitoneal immunotherapy.

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Quality of Life in Patients after Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy: Is It Worth the Risk?

Cited by 63 publications

References 24 publications

Quality of Life in Peritoneal Carcinomatosis: A Prospective Study in Patients Undergoing Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy (HIPEC)

Quality of Life in Peritoneal Carcinomatosis: A Prospective Study in Patients Undergoing Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy (HIPEC)

Survival outcomes after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for peritoneal carcinomatosis from gastric cancer: a systematic review

Current perspectives on hyperthermic intraperitoneal chemotherapy in gastric cancer

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