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Peritoneal Surface Malignancies

P50: Beyond Standard Measures: A Comprehensive Evaluation of Quality of Life in Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy Survivors

Introduction: Clinical trials and other studies evaluating the quality of life (QoL) of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS/HIPEC) patients rely on standard QoL questionnaires, which are developed for evaluating more common treatments like chemotherapy and tend to focus on tumor type. Therefore, it is likely that this select population’s unique QoL experience is not captured. We assessed the QoL among CRS/HIPEC survivors and evaluated the validity of a 22-item QoL questionnaire developed using CRS/HIPEC patient input.

Methods: A single center cross-sectional study was performed. Cancer survivors who underwent CRS/HIPEC ≥3 months prior anonymously completed a demographic/clinical survey, the FACT-G questionnaire, and the post-CRS/HIPEC QoL questionnaire. The last consisted of 22 Likert-scale and multiple choice questions developed by our group using patient input. FACT-G total score (range: 0-108) was used as a surrogate for overall QoL with low QoL defined as ≤74. We evaluated the association between different QoL drivers (morbidity, recurrence, active treatment, etc.) and the post-CRS/HIPEC QoL questionnaire answers with the FACT-G total score.

Results:

Overall, 157/471 (33.3%) survivors completed the questionnaires. Median age was 62 (IQR: 52-68) years, 82.3% (n=130) were white, 69.4% (n=109) were married, and 49.0% (n=77) were employed. Median time from diagnosis was 66 (IQR: 33-120) months. Primary tumor type included appendix (n=96), ovarian (n=38), colon (n=12), and other (n=11). Median FACT-G total score was 91 (IQR: 77-100) with 20.4% (n=32) reporting a low QoL. Overall QoL was negatively associated with comorbidities (p< 0.01), painkiller use (p< 0.01), recurrence after last treatment (p=0.02), and active cancer treatment (p=0.01). Four (Figure 1) and 10 questions of the post-CRS/HIPEC QoL questionnaire were strongly and moderately associated with overall QoL, respectively. Internal consistency between the 14 questions was excellent (Cronbach’s alpha=0.9). Attitude towards CRS/HIPEC was positive in 90.4% (n=142) of participants.

Conclusions:

Although a high proportion of CRS/HIPEC survivors reported a high QoL, they still faced issues not captured in a standard QoL questionnaire. Development of QoL assessments tailored to the unique CRS/HIPEC experience can provide a better picture of life after CRS/HIPEC, improve program development, and aid survivorship. Prospective and early postoperative evaluation of this post-CRS/HIPEC QoL questionnaire is needed.

Learning Objectives:

  • To define the factors associated with overall quality of life in CRS/HIPEC survivors.
  • To describe attitudes of CRS/HIPEC survivors toward their treatment and how it can impact their quality of life.
  • To realize the potential benefits in survivorship research of using CRS/HIPEC survivors input when evaluating quality of life.