Physical, psychological and nutritional outcomes in a cohort of Irish patients with metastatic peritoneal malignancy scheduled for cytoreductive surgery (CRS) and heated intrapertioneal chemotherapy (HIPEC): An exploratory pilot study.

Autor: Loughney L; ExWell Medical, Dublin, Ireland.; School of Health and Human Performance, Dublin City University, Dublin, Ireland.; The Royal College of Surgeons in Ireland, Dublin, Ireland., McCaffrey N; ExWell Medical, Dublin, Ireland.; School of Health and Human Performance, Dublin City University, Dublin, Ireland., Timon CM; School of Nursing, Psychotherapy and Community Health, Dublin City University, Dublin, Ireland., Grundy J; National Centre for Peritoneal Malignancy, Mater Misericordiae University Hospital Dublin, Dublin, Ireland., McCarren A; Department of Computing, Dublin City University, Dublin, Ireland., Cahill R; Department of Colorectal Surgery, Mater Misericordiae University Hospital, Dublin, Ireland., Moyna N; School of Health and Human Performance, Dublin City University, Dublin, Ireland., Mulsow J; National Centre for Peritoneal Malignancy, Mater Misericordiae University Hospital Dublin, Dublin, Ireland.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2020 Dec 09; Vol. 15 (12), pp. e0242816. Date of Electronic Publication: 2020 Dec 09 (Print Publication: 2020).
DOI: 10.1371/journal.pone.0242816
Abstrakt: Background: Treatment for peritoneal malignancy (PM) can include cytoreductive surgery (CRS) and heated intrapertioneal chemotherapy (HIPEC) and is associated with morbidity and mortality. Physical, psychological and nutritional outcomes are important pre-operatively. The aim of this pilot study was to investigate these outcomes in patients with PM before and after CRS-HIPEC.
Methods: Between June 2018 and November 2019, participants were recruited to a single-centre study. Primary outcome was cardiopulmonary exercise testing (CPET) variables oxygen uptake (VO2) at anaerobic threshold (AT) and at peak. Secondary outcome measures were upper and lower body strength, health related quality of life (HRQoL) and the surgical fear questionnaire. Exploratory outcomes included body mass index, nutrient intake and post-operative outcome. All participants were asked to undertake assessments pre CRS-HIPEC and 12 weeks following the procedure.
Results: Thirty-nine patients were screened, 38 were eligible and 16 were recruited. Ten female and 6 male, median (IQR) age 53 (42-63) years. Of the 16 patients recruited, 14 proceeded with CRS-HIPEC and 10 competed the follow up assessment at week 12. Pre-operative VO2 at AT and peak was 16.8 (13.7-18) ml.kg-1.min-1 and 22.2 (19.3-25.3) ml.kg-1.min-1, upper body strength was 25.9 (20.3-41.5) kg, lower body strength was 14 (10.4-20.3) sec, HRQoL (overall health status) was 72.5 (46.3-80) % whilst overall surgical fear was 39 (30.5-51). The VO2 at AT decreased significantly (p = 0.05) and HRQoL improved (p = 0.04) between pre and post- CRS-HIPEC. There were no significant differences for any of the other outcome measures.
Conclusion: This pilot study showed a significant decrease in VO2 at AT and an improvement in overall HRQoL at the 12 week follow up. The findings will inform a larger study design to investigate a prehabilitation and rehabilitation cancer survivorship programme.
Competing Interests: The authors have declared that no competing interests exist.
Databáze: MEDLINE
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