Colorectal and Peritoneal Oncology Centre, The Christie Hospital NHS Foundation Trust, Manchester, UK.
Department of General Surgery, Norfolk and Norwich University Hospital NHS Foundation Trust, Colney Lane, Norwich, NR4 7UY, UK.
Ann Surg Oncol. 2018 Apr;25(4):965-973. doi: 10.1245/s10434-017-6326-0. Epub 2018 Jan 8.
Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) are an established treatment for pseudomyxoma peritonei (PMP), but it is a major surgical procedure and may be associated with long-term morbidity. To date, health-related quality-of-life (HRQL) data among survivors are lacking.
A two-period qualitative study investigated patients undergoing CRS-HIPEC for PMP at a national peritoneal tumor center between 2003 and 2011. First, the European Organization for Research and Treatment (EORTC)-QLQ C30 HRQL questionnaire was used longitudinally preoperatively and at postoperative months 3, 6, 9, 12, 18, and 24, then yearly thereafter. Second, it was updated in 2016 as a cross-sectional study. Both studies were compared with age- and sex-matched reference populations (one-way t tests).
A total of 553 longitudinal HRQL questionnaires were completed for 137 patients, truncated at 60 months. In the 2016 update, 85 responses were received from 103 survivors (mean follow-up period, 8.11 years). Patients' physical, role, and social function scores were impaired until 12 months postoperatively, after which the scores did not differ significantly from those of with reference populations. Similarly, fatigue, appetite loss, insomnia, and financial difficulties worsened significantly compared with reference populations in the first 12-months and then normalized. In contrast, impaired cognitive function (82.3 vs 88.5; P = 0.017), constipation (13.7 vs 7.3; P = 0.032), and diarrheal symptoms (15.1 vs 4.9; P = 0.0006) persisted through both periods. Global health scores did not differ significantly from those of the reference population.
Beyond 12 months postoperatively, CRS-HIPEC for PMP is associated with a good quality of life except for some cognitive functional impairment and bowel disturbances.
细胞减灭术（CRS）和腹腔内热灌注化疗（HIPEC）是假性黏液瘤腹膜病（PMP）的标准治疗方法，但这是一项重大的手术，可能会导致长期发病。迄今为止，尚无生存者的健康相关生活质量（HRQL）数据。
一项为期 2 期的定性研究调查了 2003 年至 2011 年间在国家腹膜肿瘤中心接受 CRS-HIPEC 治疗的 PMP 患者。首先，使用欧洲癌症研究与治疗组织（EORTC）-QLQ C30 HRQL 问卷进行了纵向术前和术后 3、6、9、12、18 和 24 个月的随访，然后每年进行一次。其次，在 2016 年作为横断面研究进行了更新。将这两项研究与年龄和性别匹配的参考人群（单向 t 检验）进行了比较。
共完成了 137 例患者的 553 份纵向 HRQL 问卷，随访时间截点为 60 个月。在 2016 年的更新中，从 103 名幸存者中收到了 85 份回复（平均随访时间为 8.11 年）。患者的身体、角色和社会功能评分在术后 12 个月内受损，此后与参考人群的评分无显著差异。同样，疲劳、食欲减退、失眠和经济困难在术后前 12 个月内与参考人群相比显著恶化，然后恢复正常。相比之下，认知功能障碍（82.3 对 88.5；P=0.017）、便秘（13.7 对 7.3；P=0.032）和腹泻症状（15.1 对 4.9；P=0.0006）在两个时期均持续存在。总体健康评分与参考人群无显著差异。
CRS-HIPEC 治疗 PMP 后 12 个月，除一些认知功能障碍和肠道紊乱外，生活质量良好。
