Long-Term Survivorship and Quality of Life After Cytoreductive Surgery Plus Intraperitoneal Hyperthermic Chemotherapy for Peritoneal Carcinomatosis Richard P. McQuellon, PhD, Brian W. Loggie, MD, Anna B. Lehman, MA, Gregory B. Russell, MS, Ronald A. Fleming, PharmD, Perry Shen, MD, and Edward A. Levine, MD Background: Cytoreductive surgery plus intraperitoneal hyperthermic chemotherapy with mit- omycin C for peritoneal carcinomatosis is used as a palliative treatment for a variety of malignan- cies. The purpose of this study was to measure the quality of life (QOL) of survivors (3 years) after treatment. Methods: Patients were interviewed by telephone with the following tools: (1) the Functional Assessment of Cancer Therapy–Colon (FACT-C), (2) the Short Form of the Medical Outcomes Study Questionnaire, (3) the Center for Epidemiologic Studies–Depression scale, (4) the Life Appreciation scale, (5) the Psychosocial Concerns Questionnaire, and (6) performance status rating. Results: Seventeen (10 appendix, 5 large intestine, 1 ovarian, and 1 peritoneum) of 109 patients were interviewed from 3.1 to 8.0 years after treatment. Ten patients (62.5%) described their health as excellent or very good. No limitations on moderate activity were reported in 94% of cases. Paired t-tests were used to compare 10 patients who had baseline QOL data. FACT mean difference scores and P values (positive difference scores indicate improved QOL) were functional well-being: 4.9, P = .01; physical well-being: 3.3, P = .05; and FACT total: 14.3, P = .02. Conclusions: Long-term survival with good QOL is possible for selected patients with peritoneal carcinomatosis after cytoreductive surgery plus intraperitoneal hyperthermic chemotherapy. Key Words: Quality of life—Intraperitoneal hyperthermic chemotherapy—Survivorship—Peri- toneal carcinomatosis. Peritoneal carcinomatosis (PC) is associated with poor prognosis and diminished quality of life (QOL). 1,2 Sur- vival is often estimated in months, 3 and the patient’s functional status may be severely hampered. Most clini- cians do not consider curative options for patients with PC, but rather consider comfort and palliation of symp- toms. Long-term survival is rare in this patient popula- tion treated with conventional therapy. 4,5 A phase II clinical trial conducted at Wake Forest University School of Medicine used cytoreductive surgery plus intraperito- neal hyperthermic chemotherapy (IPHC) in 109 patients treated for a variety of diagnoses. 6 A subsample of these patients (n = 64) had baseline QOL and follow-up QOL measurements assessed at four different time points over 1 year. Results of the QOL study indicated that survivors tolerated the treatment reasonably well and returned to baseline QOL within 3 months after treatment. 7 Long-term survivorship issues are quite different from what might be expected within the first 6 to 12 months after intensive treatment for any form of cancer. Often, many patients may experience significant threats to QOL immediately after intensive treatments. 8 However, with the prospect of returning to a normal life, patients may be Received March 15, 2002; accepted September 24, 2002. From the Departments of Internal Medicine (RPM, ABL, RAF), Section of Hematology and Oncology, Public Health Sciences (GBR), and General Surgery (PS, EAL), The Surgical Oncology Service, Wake Forest University School of Medicine, Winston-Salem, North Carolina; and the Surgical Oncology Section (BWL), Creighton University, Omaha, Nebraska. Address correspondence and reprint requests to: Richard P. McQuel- lon, PhD, Comprehensive Cancer Center of Wake Forest University, Medical Center Blvd., Winston-Salem, NC 27157-1082; Fax: 336-716- 5687; E-mail: rmcquell@wfubmc.edu. Published by Lippincott Williams & Wilkins © 2003 The Society of Surgical Oncology, Inc. Annals of Surgical Oncology, 10(2):155–162 DOI: 10.1245/ASO.2003.03.067 155