Division of Surgical Oncology, Department of Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Ann Surg Oncol. 2020 Oct;27(10):3973-3983. doi: 10.1245/s10434-020-08379-9. Epub 2020 Apr 26.
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.
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.
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%.
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.
先前的研究表明，总体而言，细胞减灭术联合腹腔热灌注化疗（CRS+HIPEC）后 3-6 个月内生活质量（QoL）下降，6-12 个月内恢复到基线水平。本系统评价旨在评估术后 12 个月内影响 CRS+HIPEC 后 QoL 的因素。
电子数据库搜索了截至 2019 年 9 月报告使用有效问卷评估 QoL 的文章。使用非随机研究方法学指数工具评估偏倚风险。主要结局为 CRS+HIPEC 后短期（术后<6 个月）和中期（术后 6-12 个月）生活质量决定因素。次要结局为 QoL 和随时间报告的症状。
我们纳入了 14 项研究，使用了 12 种不同的问卷。报告的数据是前瞻性或回顾性收集的，涉及 1556 例患者（四项研究中有<50%的患者脱落）。总体而言，研究显示术后 3 个月内 QoL 下降，12 个月时恢复到基线或更高水平。QoL 受年龄较高、女性、手术时间延长、广泛疾病、残留疾病、辅助化疗、并发症、造口术和复发病等因素的负面影响。在研究中，QoL 结果具有可比性，脱落率在 50%以上和以下。
如果疾病不复发，CRS+HIPEC 后 12 个月内 QoL 恢复到基线水平，且该恢复过程受多种因素影响。
