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

Ch. Bakkers, V.C.J. van de Vlasakker, K.P.B. Rovers, R.J. Lurvink, S.W. Nienhuijs, J.W.A. Burger, G.M. Creemers, C.S. Bonhof, F. Mols, I.H.J.T. de Hingh*

*Corresponding author for this work

Research output: Contribution to journalArticleScientificpeer-review

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Abstract

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.
Original languageEnglish
Article number788
Number of pages14
JournalCancers
Volume15
Issue number3
DOIs
Publication statusPublished - 2023

Keywords

  • COLORECTAL-CANCER
  • CRS-HIPEC
  • METASTASES
  • MORBIDITY
  • PERITONEAL CARCINOMATOSIS
  • PROGNOSTIC-FACTORS
  • QLQ-C30
  • QUALITY-OF-LIFE
  • RANDOMIZED-TRIAL
  • SYSTEMIC CHEMOTHERAPY
  • THERAPY
  • colorectal neoplasms
  • cytoreduction
  • patient-reported outcome measures
  • peritoneal neoplasms
  • quality of life
  • surgical procedures

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