Quality of life following cytoreductive surgery and hyperthermic intraperitoneal chemotherapy: a Canadian experience

Background: Cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) is an effective treatment for select peritoneal surface malignancies, offering a survival benefit. However, the procedure can substantially impact patients’ quality of life (QoL) owing to its physiologic and functional effects. We sought to evaluate QoL trajectories over 12 months following CRS/HIPEC and to identify factors influencing outcomes. Methods: A prospective cohort study was performed including patients undergoing CRS/HIPEC between January 2018 and July 2022. Quality of life was assessed preoperatively and at 3, 6, and 12 months postoperatively using the European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 and QLQ-CR29 questionnaires. Qualitative data from open-ended responses were analyzed thematically. Results: Twenty-five patients were included in the study. Global health scores declined at 3 months (p = 0.024) but returned to near baseline by 12 months. Physical function showed similar recovery, and cognitive function improved significantly by 6 months (p = 0.017). Sexual function showed increased interest (p < 0.001) but worsening symptoms. Key QoL predictors included age, sex, postoperative complications, systemic therapy, and recurrence. Family support, medical care, and active lifestyles positively influenced recovery, whereas prognosis concerns and physical limitations were negative factors. Conclusion: Quality of life after CRS/HIPEC showed dynamic recovery over 12 months and was influenced by clinical, demographic, and psychosocial factors, emphasizing the need for comprehensive perioperative support.