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Survival and Health Outcomes After Cytoreductive Surgery With Intraperitoneal Hyperthermic Chemotherapy for Disseminated Peritoneal Cancer of Appendiceal Origin

¹ Department of Internal Medicine, Section of Hematology and Oncology, Wake Forest University School of Medicine, Medical Center Blvd, Winston-Salem, North Carolina 27157-1082, USA
² Department of Biostatistical Sciences, Section of Biostatistics, Wake Forest University School of Medicine, Medical Center Blvd, Winston-Salem, North Carolina 27157-1082, USA
³ Surgical Oncology Service, Section of Surgical Oncology, Wake Forest University School of Medicine, Medical Center Blvd, Winston-Salem, North Carolina 27157-1082, USA

Correspondence: Address correspondence and reprint requests to: Richard P. McQuellon, PhD; E-mail: rmcquell{at}wfubmc.edu

Background: Cytoreductive surgery with intraperitoneal hyperthermic chemotherapy for peritoneal carcinomatosis of appendiceal origin can alleviate symptoms and prolong survival. This aggressive therapy may impair patient quality of life (QOL). The purpose of this study was to monitor health outcomes before and after treatment.

Methods: Patients underwent cytoreductive surgery and intraperitoneal hyperthermic chemotherapy for peritoneal cancer. Patients completed questionnaires consisting of demographic information and the Functional Assessment of Cancer Therapy, the SF-36 Medical Outcomes Study survey, the Center for Epidemiologic Studies—Depression Scale, and the ECOG Performance Status Rating before (T1) and after surgery at 3 (T2), 6 (T3), 12 (T4), and 24 (T5) months. Time trends were assessed with the mixed model (SAS PROC MIXED) to allow use of all the observed data as well as to account for missing data.

Results: Fifty-eight patients (50% female) with a mean age 52.4 years (SD 12.6; range, 28–80) were assessed before surgery. Overall survival at 1 year was 78.7%. Emotional well-being improved over the study period, while physical well-being and physical functioning declined at T2 and then improved to near baseline levels at T3 and T4. Percentage of patients with depressive symptoms was as follows: T1 = 24%, T2 = 30%, T3 = 24%, and T4 = 33%. QOL scores improved over time.

Conclusions: Although complications can affect short-term recovery, survival in appendix cancer patients with peritoneal cancer is good and for some can be achieved without major decrements in QOL at 1 year. Depressive symptoms and some physical limitations remain in surviving patients.

Key Words: Health outcomes • Intraperitoneal hyperthermic chemotherapy

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				E. A. Levine, B. M. Ronnett, P. F. Mansfield, and C. Eng Overview of Cytoreductive Surgery and Intraperitoneal Hyperthermic Chemotherapy for Peritoneal Dissemination of Appendiceal and Colorectal Neoplasms ASCO Educational Book, January 1, 2008; 2008(1): 153 - 159. [Abstract] [Full Text] [PDF]