Quality of Life in Patients after Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy: Is It Worth the Risk?
Quality of Life in Patients after Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy: Is It Worth the Risk?
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DOI：
10.1245/s10434-012-2579-9
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发表时间：
2013-01-01
影响因子：
3.7
通讯作者：
Hartmann, Jens
中科院分区：
文献类型：
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作者：
Tsilimparis, Nikolaos;Bockelmann, Christina;Hartmann, Jens
研究腹膜癌病（PC）患者在完全细胞减灭术（CRS）和腹腔热化疗（HIPEC）后随时间推移的健康相关生活质量（HQL）。采用欧洲癌症研究和治疗组织生活质量问卷进行的一项非随机队列研究。90例在我们机构接受CRS和HIPEC治疗PC的患者入选在研究中。平均年龄为56岁（范围27-77岁）（61%为女性）。原发肿瘤为结直肠癌21%，卵巢癌19%，腹膜假粘液瘤16%，阑尾肿瘤16%，胃癌10%，腹膜间皮瘤13%。平均腹膜癌病指数为22（范围2-39）。术前平均总体健康状况评分为69 +/- A 25，第1、6、12、24和36个月时分别为55 +/- A 20、66 +/- A 22、66 +/- A 23、71 +/- A 23和78 +/- A 21。身体和角色功能在6个月时显著恢复，在24个月测量时接近基线。情绪功能从低基线开始，到第12个月恢复到基线。随访时认知和社会功能恢复缓慢。疲劳、腹泻、呼吸困难和睡眠障碍是6个月随访时持续存在的症状，幸存者随后有所改善。CRS和HIPEC后的幸存者术后生活质量与术前相似，大多数减少的元素在6-12个月后恢复。我们的结论是，CRS和HIPEC后患者的生活质量下降不应被用作拒绝对这些患者进行手术治疗的论据。
To investigate the course of health-related quality of life (HQL) over time in patients with peritoneal carcinomatosis (PC) after complete cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC).Prospective, single-center, nonrandomized cohort study using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire.Ninety patients who underwent CRS and HIPEC for PC in our institution were enrolled in the study. Mean age was 56 years (range 27-77 years) (61 % female). Primary tumor was colorectal in 21 %, ovarian in 19 %, pseudomyxoma peritonei in 16 %, an appendix tumor in 16 %, gastric cancer in 10 %, and peritoneal mesothelioma in 13 % of cases. Mean peritoneal carcinomatosis index was 22 (range 2-39). Mean global health status score was 69 +/- A 25 preoperatively and 55 +/- A 20, 66 +/- A 22, 66 +/- A 23, 71 +/- A 23, and 78 +/- A 21 at months 1, 6, 12, 24, and 36, respectively. Physical and role function recovered significantly at 6 months and were close to baseline at the 24-month measurement. Emotional function starting from a low baseline recovered to baseline by month 12. Cognitive and social function had slow recovery on follow-up. Fatigue, diarrhea, dyspnea, and sleep disturbance were symptoms persistent at 6-month follow-up, improving later on in survivors.Survivors after CRS and HIPEC have postoperative quality of life similar to preoperatively, with most of the reduced elements recovering after 6-12 months. We conclude that reduced quality of life of patients after CRS and HIPEC should not be used as an argument to deny surgical therapy to these patients.