TY - JOUR
T1 - The Impact of Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy (CRS-HIPEC) versus Conventional Surgery on Patient-Reported Outcomes: A Comparative Cohort Study between the CAIRO6 Trial and the PROCORE Study
AU - Bakkers, C.
AU - van de Vlasakker, V.C.J.
AU - Rovers, K.P.B.
AU - Lurvink, R.J.
AU - Nienhuijs, S.W.
AU - Burger, J.W.A.
AU - Creemers, G.J.M.
AU - Bonhof, C.S.
AU - Mols, F.
AU - de Hingh, I.H.J.T.
N1 - Funding Information:
De Hingh: An unrestricted research grant from RanD/QP&S and Roche, paid to the institute, unrelated to the submitted work. All other authors did not have any disclosures.
Funding Information:
The CAIRO6 trial is funded by the Dutch Cancer Society (grant number 10795) and F. Hoffman-La Roche (grant number ML39718). The PROCORE study was funded by the Netherlands Comprehensive Cancer Organisation, Utrecht, the Netherlands; the Center of Research on Psychological and Somatic Disorders (CoRPS), Tilburg University, the Netherlands; and an Investment Grant Large of the Dutch Research Council (2016/04981/ZONMW-91101002). The funders had no role in study design, in the collection, analysis, and interpretation of data, in the writing of the report, and in the decision to submit the article for publication.
Publisher Copyright:
© 2023 by the authors.
PY - 2023/2/1
Y1 - 2023/2/1
N2 - Simple Summary Patients treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) are at risk of significant treatment burden. Multiple studies have reported on patient-reported outcome (PRO) measurements of these patients. However, outcomes are difficult to interpret as no comparison has been made between CRS-HIPEC and conventional surgery. The present study compares several PROs at three different timepoints between patients with colorectal peritoneal metastases treated with CRS-HIPEC and colorectal cancer (CRC) patients treated with conventional surgery. PROs were obtained from two Dutch prospective trials. Despite a more extensive procedure with greater risk of morbidity, CRS-HIPEC in patients with colorectal peritoneal metastases did not have a greater negative impact on PROs than conventional surgery in patients with CRC. Furthermore, systemic therapy did not affect these PROs. These findings may facilitate future patient counseling and shared decision making in clinical practice. Purpose-To compare patient-reported outcomes (PROs) of patients undergoing cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) for colorectal peritoneal metastases to PROs of colorectal cancer (CRC) patients undergoing conventional surgery. Methods-Data were extracted from the CAIRO6 trial (CRS-HIPEC group) and the PROCORE study (conventional surgery group). Nine predefined PROs (derived from the EORTC QLQ-C30 questionnaire) were compared at baseline, in the early postoperative period and one year postoperatively, with correction for treatment with systemic therapy using linear mixed modeling. Results-In total, 331 patients were included: 71 in the CRS-HIPEC group and 260 in the conventional surgery group. All predefined PROs (fatigue, diarrhea, C30 summary score, Global Health Status, physical, role, emotional, cognitive, and social functioning) did not differ significantly between the groups at all three timepoints, and differential effects over time for all PROs did not differ significantly between the groups. Significant worsening of fatigue, C30 summary score, physical and role functioning (both groups), and cognitive and social functioning (conventional surgery group only) was present in the early postoperative period. All scores returned to baseline at one year postoperatively, except for physical and cognitive functioning in the conventional surgery group. Emotional functioning improved postoperatively in both groups compared to baseline. Conclusion-Despite a more extensive procedure with greater risk of morbidity, CRS-HIPEC in patients with colorectal peritoneal metastases did not have a greater negative impact on PROs than conventional surgery in patients with CRC. Further, systemic therapy did not affect these PROs. These findings may facilitate future patient counseling and shared decision making in clinical practice.
AB - Simple Summary Patients treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) are at risk of significant treatment burden. Multiple studies have reported on patient-reported outcome (PRO) measurements of these patients. However, outcomes are difficult to interpret as no comparison has been made between CRS-HIPEC and conventional surgery. The present study compares several PROs at three different timepoints between patients with colorectal peritoneal metastases treated with CRS-HIPEC and colorectal cancer (CRC) patients treated with conventional surgery. PROs were obtained from two Dutch prospective trials. Despite a more extensive procedure with greater risk of morbidity, CRS-HIPEC in patients with colorectal peritoneal metastases did not have a greater negative impact on PROs than conventional surgery in patients with CRC. Furthermore, systemic therapy did not affect these PROs. These findings may facilitate future patient counseling and shared decision making in clinical practice. Purpose-To compare patient-reported outcomes (PROs) of patients undergoing cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) for colorectal peritoneal metastases to PROs of colorectal cancer (CRC) patients undergoing conventional surgery. Methods-Data were extracted from the CAIRO6 trial (CRS-HIPEC group) and the PROCORE study (conventional surgery group). Nine predefined PROs (derived from the EORTC QLQ-C30 questionnaire) were compared at baseline, in the early postoperative period and one year postoperatively, with correction for treatment with systemic therapy using linear mixed modeling. Results-In total, 331 patients were included: 71 in the CRS-HIPEC group and 260 in the conventional surgery group. All predefined PROs (fatigue, diarrhea, C30 summary score, Global Health Status, physical, role, emotional, cognitive, and social functioning) did not differ significantly between the groups at all three timepoints, and differential effects over time for all PROs did not differ significantly between the groups. Significant worsening of fatigue, C30 summary score, physical and role functioning (both groups), and cognitive and social functioning (conventional surgery group only) was present in the early postoperative period. All scores returned to baseline at one year postoperatively, except for physical and cognitive functioning in the conventional surgery group. Emotional functioning improved postoperatively in both groups compared to baseline. Conclusion-Despite a more extensive procedure with greater risk of morbidity, CRS-HIPEC in patients with colorectal peritoneal metastases did not have a greater negative impact on PROs than conventional surgery in patients with CRC. Further, systemic therapy did not affect these PROs. These findings may facilitate future patient counseling and shared decision making in clinical practice.
KW - colorectal neoplasms
KW - peritoneal neoplasms
KW - cytoreduction
KW - surgical procedures
KW - CRS-HIPEC
KW - patient-reported outcome measures
KW - quality of life
KW - QUALITY-OF-LIFE
KW - PERITONEAL CARCINOMATOSIS
KW - COLORECTAL-CANCER
KW - SYSTEMIC CHEMOTHERAPY
KW - PROGNOSTIC-FACTORS
KW - RANDOMIZED-TRIAL
KW - METASTASES
KW - MORBIDITY
KW - THERAPY
KW - QLQ-C30
U2 - 10.3390/cancers15030788
DO - 10.3390/cancers15030788
M3 - Article
C2 - 36765746
SN - 2072-6694
VL - 15
JO - Cancers
JF - Cancers
IS - 3
M1 - 788
ER -