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. 2020 Oct;27(10):3973-3983.
doi: 10.1245/s10434-020-08379-9. Epub 2020 Apr 26.

Systematic Review of Factors Affecting Quality of Life After Cytoreductive Surgery with Hyperthermic Intraperitoneal Chemotherapy

Maleen Leimkühler  1 , Judith E K R Hentzen  1 , Patrick H J Hemmer  1 , Lukas B Been  1 , Robert J van Ginkel  1 , Schelto Kruijff  1 , Barbara L van Leeuwen  1 , Geertruida H de Bock  2
Affiliations

Systematic Review of Factors Affecting Quality of Life After Cytoreductive Surgery with Hyperthermic Intraperitoneal Chemotherapy

Maleen Leimkühler et al. Ann Surg Oncol. 2020 Oct.

Abstract

Background: Previous studies have shown that, overall, quality of life (QoL) decreases within the first 3-6 months after cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS + HIPEC), returning to baseline levels by 6-12 months. This systematic review aims to evaluate the factors affecting QoL after CRS + HIPEC within 12 months of surgery.

Methods: Electronic databases were investigated searching for articles reporting QoL with validated questionnaires up to September 2019. Risk of bias was assessed with the methodological index for non-randomized studies tool. The primary outcomes were short-term (< 6 months after surgery) and medium-term (6-12 months after surgery) determinants of QoL after CRS + HIPEC. Secondary outcomes were QoL and reported symptoms over time.

Results: We included 14 studies that used 12 different questionnaires. The reported data were collected prospectively or retrospectively for 1556 patients (dropout < 50% in four studies). Overall, studies showed diminished QoL within 3 months after surgery and a recovery to baseline or greater by 12 months. QoL was negatively influenced by higher age, female sex, prolonged operation time, extensive disease, residual disease, adjuvant chemotherapy, complications, stoma placement, and recurrent disease. QoL results were comparable between studies, with dropout rates above and below 50%.

Conclusions: QoL returns to baseline levels within 12 months after CRS + HIPEC provided the disease does not recur, and this recovery process is influenced by several factors.

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Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

Fig. 1
Fig. 1
Flowchart of systematic review. HIPEC hyperthermic intraperitoneal chemotherapy, IPC intraperitoneal chemotherapy, QoL quality of life, SPIC sequential perioperative intraperitoneal chemotherapy
Fig. 2
Fig. 2
Dropout rates. CRS cytoreductive surgery, HIPEC hyperthermic intraperitoneal chemotherapy
Fig. 3
Fig. 3
Overall QoL. EORTC QLQ-C30 European Organisation for Research and Treatment of Cancer Quality of Life of Cancer Patients, FACT Functional Assessment of Cancer Therapy, GIQLI Gastrointestinal Quality of Life index, QoL quality of life
Fig. 4
Fig. 4
QoL by domain. EORTC QLQ-C30 European Organisation for Research and Treatment of Cancer Quality of Life of Cancer Patients, FACT Functional Assessment of Cancer Therapy, GIQLI Gastrointestinal Quality of Life index, QoL quality of life
See this image and copyright information in PMC

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