Impairments in Bowel Function, Social Function and Quality of Life After Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy.

Ann Surg Oncol 2020 Jan 9;27(1):124-131. Epub 2019 May 9.

Division of General Surgery, Department of Surgery, University of Toronto, Toronto, ON, Canada.

Background: Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) can be associated with decreases in quality of life (QOL). Bowel-related QOL (BR-QOL) after CRS-HIPEC has not been previously studied. The objectives of the current study were to examine the effect of different types of bowel resection during CRS-HIPEC on overall QOL and BR-QOL.

Methods: A prospective cohort study was performed. QOL data were collected using the European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 and CR-29 questionnaires at 3, 6, and 12 months after CRS-HIPEC. Patients were divided into groups that underwent no bowel resection, non-low anterior resection (LAR) bowel resection, LAR, and LAR with stoma. Primary outcomes were global QOL and BR-QOL.

Results: Overall, 158 patients were included in this study. Bowel resections were performed in 77% of patients, with 31% undergoing LAR. Global QOL was not significantly different between groups. LAR patients (with and without stoma) had significantly worse BR-QOL, embarrassment, and altered body image, with LAR + stoma patients having the largest impairments in these domains. Trends toward higher levels of impotence and anxiety were also seen in LAR patients. Although global QOL improved over time, impairments in BR-QOL and sexual and social function did not significantly improve over time.

Conclusions: Although global QOL after CRS-HIPEC was not affected by the type of bowel resection, the use of LAR and ostomies was associated with clinically meaningful and persistent impairments in BR-QOL and related functional domains. Generic QOL questionnaires may not adequately capture these domains; however, targeted questionnaires in these patients may help improve QOL after CRS-HIPEC.

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http://dx.doi.org/10.1245/s10434-019-07385-wDOI Listing
January 2020
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References

(Supplied by CrossRef)

L Lemoine et al.
World J Gastroenterol. 2016

S Marmor et al.
J Gastrointest Surg. 2015

V Verma et al.
Ann Surg Oncol. 2018

SJ Henley et al.
Int J Occup Environ Health 2013

DG Jayne et al.
Br J Surg. 2002

J Segelman et al.
Br J Surg. 2012

EA Levine et al.
Journal of the American College of Surgeons. 2014

R Mcquellon et al.
J Surg Oncol. 2008

Rebecca M. Dodson et al.
Annals of Surgical Oncology 2016

C Seretis et al.
Eur J Surg Oncol. 2014

N Kopanakis et al.
J BUON. 2018

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