Patients' Lived Experiences After Cytoreductive Surgery and HIPEC for Peritoneal Carcinomatosis from GI Malignancies: A Qualitative Study.

BACKGROUND

Current literature on quality of life (QOL) after cytoreductive surgery and heated intraperitoneal chemotherapy (CRS/HIPEC) demonstrates that most patients have a temporary decline in QOL with a return to baseline 3-12 months postoperatively. This qualitative study aimed to explore patient perceptions of QOL and to understand how adaptation influences their experiences.

METHODS

The study involved 1 h semi-structured interviews with patients who underwent CRS/HIPEC for non-low-grade appendiceal mucinous neoplasm lower gastrointestinal (GI) pathology from May 2023 to March 2024. The interview guide focused on patients' QOL after CRS/HIPEC, with a focus on patient adaptation. Interview transcripts were analyzed using the constant comparative method to identify recurrent themes.

RESULTS

Of 18 patients, 14 participated (median age, 57; 50 % women) a median of 16.9 months after surgery. The study identified 6 major themes and 19 subthemes. The six major themes were low baseline QOL, hope, emotional QOL, physical QOL, a "new normal," and response shift. Most participants described low QOL before CRS/HIPEC, hope upon learning about this treatment, and variable recovery experiences. Fatigue and long-term limitations on functional status were common, leading to inability to work and social isolation. Most patients accepted this new baseline QOL and adapted to it.

DISCUSSION: Patients undergoing CRS/HIPEC often have persistent physical and emotional impacts on QOL. These often improve over time as patients adapt to their new baseline QOL. These findings highlight the importance of addressing functional status and its impacts with CRS/HIPEC patients. In addition, future QOL research should account for the effects of response shift.