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Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy postoperative symptomatology: palliative care impact
  1. Abigail P Sneider1,
  2. Ankit Dhiman2,
  3. Ryan Morgan2,
  4. Sandy Tun3,
  5. Kiran K Turaga4 and
  6. Oliver S Eng5
  1. 1 Pritzker School of Medicine, University of Chicago, Chicago, Illinois, USA
  2. 2 Department of Surgery, University of Chicago, Chicago, Illinois, USA
  3. 3 Department of Medicine, Section of Geriatrics and Palliative Medicine, University of Chicago, Chicago, Illinois, USA
  4. 4 Department of Surgery, Division of Surgical Oncology, Yale University, New Haven, Connecticut, USA
  5. 5 Department of Surgery, Division of Surgical Oncology, University of California Irvine, Orange, California, USA
  1. Correspondence to Dr Oliver S Eng, Department of Surgery, Division of Surgical Oncology, University of California Irvine, Orange, CA, 92868, USA; oeng{at}hs.uci.edu

Abstract

Objectives Palliative care (PC) for patients with advanced cancer has been associated with improved symptom burden and quality of life (QoL). This study aimed to characterise postoperative symptoms of cytoreductive surgery (CRS)/hyperthermic intraperitoneal chemotherapy (HIPEC) patients and to assess PC impact by analysing symptom burden before and after PC interventions.

Methods CRS/HIPEC patients with two PC visits within 5 months postoperatively (2016–2021) at a tertiary care centre were identified from a retrospective database. For each patient, documentation of QoL-associated symptoms at the initial PC visit and changes in symptomatology at the second PC visit were recorded. Descriptive statistics were performed.

Results 46 patients were included in this study. Median age was 62.2 (range 31.9–84.6) years. Median peritoneal cancer index was 23.5 (range 0–39). The most common histologies were colorectal (32.6%) and appendiceal (30.4%). Symptoms most frequently reported were pain (84.8%), fatigue (54.3%) and appetite loss/change (52.2%). Following PC interventions, most symptoms were stable or improved. The mean number of symptoms per patient was 3.7, with an average of 3.5 improved/stable and 0.5 worse/new onset at follow-up (p<0.001).

Conclusion CRS/HIPEC patients experienced a high QoL-associated symptom burden. Following postoperative PC interventions, significantly more symptoms were reported as improved/stable, compared with worse/new onset.

  • Cancer
  • Quality of life
  • Symptoms and symptom management

https://doi.org/10.1136/spcare-2023-004273

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    Footnotes

    • Twitter @a_dhiman91

    • Contributors APS—conceptualisation (equal), data curation (equal), investigation (lead), formal analysis (lead) and writing (original draft) (lead). AD—data curation (equal), formal analysis (supporting) and writing (review and editing) (equal). RM—writing (review and editing) (equal). ST—investigation (supporting) and writing (review and editing) (equal). KKT—investigation (supporting) and writing (review and editing) (equal). OSE—conceptualisation (equal), investigation (equal), formal analysis (supporting), supervision (lead) and writing (original draft) (supporting).

    • Funding This research was supported by the Scholars in Oncology Associated Research (SOAR) Program through NIH/NCI grant #R25CA240134.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; internally peer reviewed.