Prospective longitudinal study of quality of life following cytoreductive surgery and intraperitoneal chemotherapy for pseudomyxoma peritonei

Background: Pseudomyxoma peritonei (PMP) is characterized by mucinous ascites, predominantly arising form a perforated tumour of the appendix. This study aimed to assess Health-Related Quality of Life (HRQL) in patients following cytoreductive surgery and intraperitoneal chemotherapy for PMP. Methods: Over a one year period, 49 consecutive patients (13 male, 36 females) with a median age of 55 (range 37-81 years) were enrolled. Patients were asked to complete the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 questionnaire prior to surgery and at one, three, six and twelve months post-operatively. Results: 26 patients (53%) underwent complete cytoreduction and 20 (42%) patients had major tumour debulking. One patient died from progressive disease three months from surgery and two patients withdrew from the study within 6 months of surgery. Baseline questionnaire compliance was 100 per cent and remained high (overall 98% of eligible patients) during follow up. Grade III/IV morbidity occurred in 4 patients (9%). Patients undergoing both complete cytoreduction and major tumour debulking reported a clinically significant improvement in emotional well-being, appetite and global HRQL at I year following surgery. Conclusion: Despite the high morbidity associated with cytoreductive surgery and intraperitoneal chemotherapy, an improvement in quality of life at 1 year following the procedure was seen following both complete cytoreduction and major tumour debulking. Longer term assessment is required to demonstrate the durability of this enhancement. (C) 2010 Elsevier Ltd. All rights reserved.