Abstract
Background
The impact of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) on quality of life (QoL) for patients taking opioids and psychotropic medications preoperatively is unclear.
Methods
This study retrospectively reviewed a CRS-HIPEC single-center prospectively maintained database for 2012–2016. Demographics and clinical data on opioids/psychotropic medication use were collected via chart review. The study collected QoL outcomes at baseline, then 3, 6, and 12 months postoperatively via the Center for Epidemiologic Studies Depression Scale (CES-D), Brief Pain Inventory, Functional Assessment of Cancer Therapy, and 36-Item Short-Form Health Survey. Differences in QoL between the groups were calculated using repeated measures analysis of variance regression. Descriptive statistics and Kaplan-Meier analyses were performed.
Results
Of 388 patients, 44.8% were taking opioids/psychotropic medications preoperatively. At baseline, those taking opioids/psychotropic medications preoperatively versus those not taking these medications had significantly worse QoL. By 1 year postoperatively, the QoL measures did not differ significantly except for emotional functioning (e.g., no medications vs. opioids/psychotropic medications: CES-D, 5.6 vs. 10.1). Median survival did not differ significantly (opioids/psychotropic medications vs. no medications: 52.3 vs. 60.6 months; p = 0.66). At 1 year after surgery, a greater percentage of patients were taking opioids, psychotropic medications, or both than at baseline (63.2% vs. 44.8%; p < 0.001).
Conclusion
Despite worse baseline QoL, patients who took opioids/psychotropic medications had QoL scores 1 year postoperatively similar to the scores of those who did not except in the emotional domains. These data point to the potential utility of a timed psychosocial intervention to enhance emotional adaptation and further support the role of CRS-HIPEC in improving QoL.
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Acknowledgment
The authors acknowledge the support of the Wake Forest Baptist Comprehensive Cancer Center Biostatistics Shared Resource, supported by the National Cancer Institute’s Cancer Center Support Grant award no. P30CA012197. The content of this study is solely the responsibility of the authors and does not necessarily represent the official views of the National Cancer Institute.
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Appendices
Appendix 1: Presence of documented psychiatric diagnoses among those taking opioids and/or psychotropic (psych) medications (meds) before CRS-HIPEC
Diagnosis | No psych meds (n = 214) n (%) | Opioids (n = 102) n (%) | Anxiolytics (n = 73) n (%) | Antidepressants (n = 73) n (%) | Antipsychotics (n = 4) n (%) | Other psych med (n = 5) n (%) | Any med (n = 174) n (%) | Opioids only (n = 51) n (%) | Psych meds only (n = 72) n (%) | Opioids + psych meds (n = 51) n (%) |
|---|---|---|---|---|---|---|---|---|---|---|
No psych history documented | 209 (97.7) | 72 (70.6) | 44 (60.3) | 27 (37.0) | 2 (50) | 2 (40) | 107 (61.5) | 46 (90.2) | 35 (48.6) | 26 (51) |
Depression | 2 (0.9) | 21 (20.6) | 17 (23.3) | 38 (52.1) | 1 (25) | 2 (40) | 45 (25.9) | 3 (5.9) | 24 (33.3) | 18 (35.3) |
Anxiety | 4 (1.9) | 13 (12.7) | 18 (24.7) | 16 (21.9) | 0 (0) | 1 (20) | 30 (17.2) | 2 (3.9) | 17 (23.6) | 11 (21.6) |
PTSD | 0 (0) | 0 (0) | 0 (0) | 1 (1.4) | 0 (0) | 0 (0) | 1 (0.6) | 0 (0) | 1 (1.4) | 0 (0) |
Bipolar | 0 (0) | 0 (0)) | 0 (0) | 1 (1.4) | 1 (25) | 1 (20) | 3 (1.7) | 0 (0) | 3 (4.2) | 0 (0) |
Other | 0 (0) | 1 (1) | 0 (0) | 1 (1.4) | 0 (0) | 0 (0) | 1 (0.6) | 0 (0) | 0 (0) | 1 (2) |
Appendix 2: QoL outcomes for those taking versus those not taking opioids only preoperatively
Instrument | Time | Opioids only (SE) | Not opioids only (SE) | Pairwise comparison (SE) | p value |
|---|---|---|---|---|---|
CES-D | Preop | 14.8 (2.4) | 11.3 (0.8) | 3.5 (2.6) | 0.17 |
3 months | 11.1 (2.9) | 11.4 (0.9) | − 0.3 (3.0) | 0.92 | |
6 months | 12.2 (2.9) | 9.6 (1.0) | 2.6 (3.0) | 0.4 | |
12 months | 12.2 (3.0) | 7.0 (1.0) | 5.1 (3.2) | 0.11 | |
Overall | 12.6 (1.4) | 9.8 (0.5) | 2.8 (1.5) | 0.06 | |
BPI (worst pain) | Preop | 4.2 (0.5) | 3.0 (0.2) | 1.2 (0.5) | 0.03 |
3 months | 3.0 (0.7) | 3.4 (0.2) | − 0.4 (0.7) | 0.6 | |
6 months | 3.2 (0.6) | 2.6 (0.2) | 0.6 (0.7) | 0.4 | |
12 months | 3.8 (0.7) | 2.5 (0.2) | 1.3 (0.7) | 0.07 | |
Overall | 3.6 (0.3) | 2.9 (0.1) | 0.8 (0.3) | 0.02 | |
BPI (least pain) | Preop | 2.4 (0.3) | 1.7 (0.1) | 0.6 (0.3) | 0.05 |
3 months | 1.3 (0.4) | 1.8 (0.1) | − 0.4 (0.4) | 0.31 | |
6 months | 2.1 (0.4) | 1.5 (0.1) | 0.5 (0.4) | 0.22 | |
12 months | 2.1 (0.4) | 1.4 (0.2) | 0.7 (0.5) | 0.13 | |
Overall | 2.0 (0.2) | 1.6 (0.07) | 0.4 (0.2) | 0.05 | |
Functional WB | Preop | 16.7 (1.5) | 20.1 (0.5) | − 3.6 (1.6) | 0.02 |
3 months | 17.2 (1.7) | 18.0 (0.6) | − 0.8 (1.8) | 0.67 | |
6 months | 19.7 (1.7) | 20.8 (0.6) | − 1.0 (1.8) | 0.58 | |
12 months | 20.3 (1.8) | 22.6 (0.6) | − 2.3 (1.9) | 0.24 | |
Overall | 18.3 (0.8) | 20.4 (0.3) | − 2.0 (0.9) | 0.02 | |
Emotional WB | Preop | 15.1 (1.1) | 16.6 (0.4) | − 1.5 (1.2) | 0.20 |
3 months | 17.3 (1.3) | 19.1 (0.4) | − 1.8 (1.3) | 0.19 | |
6 months | 18.8 (1.3) | 19.6 (0.4) | − 0.9 (1.4) | 0.52 | |
12 months | 16.6 (1.3) | 19.9 (0.5) | − 3.3 (1.4) | 0.02 | |
Overall | 17.0 (0.6) | 18.8 (0.2) | − 1.8 (0.7) | 0.0063 | |
Physical WB | Preop | 20.6 (1.3) | 22.4 (0.4) | − 1.8 (1.4) | 0.20 |
3 months | 20.8 (1.6) | 21.0 (0.5) | − 0.2 (1.6) | 0.90 | |
6 months | 21.8 (1.6) | 23.3 (0.5) | − 0.08 (2.3) | 0.97 | |
12 months | 21.9 (1.6)) | 23.9 (0.6) | − 2.0 (1.7) | 0.25 | |
Overall | 21.3 (0.8) | 22.6 (0.3) | − 1.4 (0.8) | 0.08 | |
Social WB | Preop | 23.7 (1.0) | 24.4 (0.3) | − 0.7 (1.0) | 0.5 |
3 months | 23.8 (1.1) | 24.0 (0.4) | − 0.1 (1.2) | 0.9 | |
6 months | 22.9 (1.1) | 23.8 (0.4) | − 0.8 (1.2) | 0.49 | |
12 months | 23.1 (1.2) | 24.4 (0.4)_ | − 1.4 (1.3) | 0.28 | |
Overall | 23.4 (0.6) | 24.1 (0.2) | − 0.7 (0.6) | 0.21 | |
FACT-G | Preop | 75.8 (3.9) | 83.4 | − 7.6 (4.1) | 0.5240 |
3 months | 79.2 (4.5) | 82.0 (1.5) | − 2.8 (4.8) | 0.5564 | |
6 months | 83.3 (4.5) | 87.6 (1.6) | − 4.3 (4.8) | 0.3694 | |
12 months | 81.9 (4.7) | 90.7 (1.7) | − 8.8 (5.0) | 0.0795 | |
Overall | 80.0 (2.2) | 85.9 (0.8) | − 5.9 (2.3) | 0.0104 | |
Cancer subscale | Preop | 18.3 (1.3) | 21.4 (0.4) | − 3.1 (1.4) | 0.0262 |
3 months | 20.2 (1.5) | 19.1 (0.5) | 1.0 (1.6) | 0.5274 | |
6 months | 20.3 (1.5) | 20.9 (0.5) | − 0.6 (1.6) | 0.73 | |
12 months | 20.0 (1.7) | 21.1 (0.6) | − 1.1 (1.8) | 0.5461 | |
Overall | 10.5 (0.8) | 20.7 (0.3) | − 1.1 | 0.1652 | |
FACT-G + subscale | Preop | 94.1 (4.9) | 104.7 (1.6) | − 10.6 (5.1) | 0.04 |
3 months | 99.3 (5.6) | 101.1 (1.9) | − 1.7 (5.9) | 0.8 | |
6 months | 103.6 (5.6) | 108.5 (2.0) | − 4.9 (6.0) | 0.4 | |
12 months | 100.3 (6.2) | 111.9 (2.1) | − 11.6 (6.5) | 0.08 | |
Overall | 99.3 (2.8) | 106.6 (0.9) | − 7.3 (2.9) | 0.01 | |
TOI | Preop | 54.0 (3.1) | 60.3 (1.0) | − 6.4 (3.2) | 0.05 |
3 months | 58.3 (3.5) | 59.1 (1.2) | − 0.9 (3.7) | 0.8 | |
6 months | 60.9 (3.5) | 63.9 (1.2) | − 3.0 (3.8) | 0.4 | |
12 months | 57.8 (3.9) | 65.1 (1.3) | − 7.3 (4.1) | 0.08 | |
Overall | 57.7 (1.7) | 62.1 | − 4.4 (1.8) | 0.02 | |
SF-36 mental | Preop | 34.8 (2.4) | 37.7 (0.8) | − 2.8 (2.6) | 0.27 |
3 months | 38.7 (3.1) | 36.4 (1.0) | 2.3 (3.3) | 0.48 | |
6 months | 38.5 (2.8) | 38.6 (1.1) | − 0.06 (3.0) | 0.98 | |
12 months | 36.6 (2.8) | 39.3 (1.2) | − 2.7 (3.0) | 0.37 | |
Overall | 36.9 (1.4) | 38.0 (0.5) | − 1.1 (1.5) | 0.45 | |
SF-36 physical | Preop | 39.1 (2.5) | 44.9 (0.8) | − 5.8 (2.6) | 0.028 |
3 months | 36.9 (3.2) | 39.2 (1.1) | − 2.3 (3.4) | 0.49 | |
6 months | 41.0 (2.8) | 43.6 (1.1) | − 2.6 (3.1) | 0.4 | |
12 months | 39.5 (2.8) | 43.9 (1.3) | − 4.3 (3.1) | 0.17 | |
Overall | 38.9 (1.4) | 42.9 (0.5) | –4.0 (1.5) | 0.008 |
Appendix 3: QoL outcomes for those taking versus those not taking psychotropic (psych) medications (meds) only preoperatively
Instrument | Time | Not psych meds only (SE) | Psych meds only (SE) | Pairwise comparison (SE) | p value |
|---|---|---|---|---|---|
CES-D | Preop | 10.7 (0.9) | 14.8 (1.6) | − 4.2 (1.8) | 0.02 |
3 months | 11.1 (1.0) | 12.5 (2.1) | − 1.4 (2.3) | 0.6 | |
6 months | 9.8 (1.0) | 10.2 (2.3) | − 0.3 (2.5) | 0.90 | |
12 months | 7.2 (1.1) | 9.1 (2.1) | − 2.0 (2.4) | 0.42 | |
Overall | 9.7 (0.5) | 12.0 (1.0) | − 2.3 (1.1) | 0.04 | |
BPI (worst pain) | Preop | 3.1 (0.2) | 3.1 (0.4) | 0.04 (0.4) | 0.93 |
3 months | 3.4 (0.2) | 2.8 (0.4) | 0.6 (0.5) | 0.26 | |
6 months | 2.8 (0.2) | 2.1 (0.5) | 0.70 (0.6) | 0.2 | |
12 months | 2.8 (0.3) | 2.2 (0.5) | 0.6 (0.6) | 0.28 | |
Overall | 3.0 (0.1) | 2.6 (0.2) | 0.4 (0.3) | 0.11 | |
BPI (least pain) | Preop | 1.9 (0.1) | 1.6 (0.2) | 0.2 (0.3) | 0.34 |
3 months | 1.7 (0.1) | 1.7 (0.3) | − 0.0004 (0.3) | 0.99 | |
6 months | 1.6 (0.2) | 1.8 (0.3) | − 0.2 (0.4) | 0.51 | |
12 months | 1.5 (0.2) | 1.5 (0.3) | 0.02 (0.4) | 0.96 | |
Overall | 1.7 (0.07) | 1.6 (0.1) | 0.05 (0.2) | 0.75 | |
Functional WB | Preop | 19.9 (0.5) | 19.5 (1.0) | 0.4 (1.1) | 0.72 |
3 months | 18.2 (0.6) | 16.9 (1.3) | 1.3 (1.5) | 0.37 | |
6 months | 20.8 (0.6) | 19.9 (1.4) | 1.0 (1.5) | 0.53 | |
12 months | 22.5 (0.7) | 21.8 (1.3) | 0.7 (1.5) | 0.61 | |
Overall | 20.3 (0.3) | 19.6 (0.6) | 0.8 (0.7) | 0.25 | |
Emotional WB | Preop | 16.8 (0.4) | 15.1 (0.7) | 1.7 (0.8) | 0.04 |
3 months | 18.9 (0.4) | 18.9 (1.0) | 0.02 (1.1) | 0.98 | |
6 months | 19.7 (0.5) | 18.8 (1.0) | 0.8 (1.1) | 0.46 | |
12 months | 19.7 (0.5) | 19.0 (0.9) | 0.7 (1.1) | 0.52 | |
Overall | 18.8 (0.2) | 17.8 (0.4) | 0.9 (0.5) | 0.06 | |
Physical WB | Preop | 22.3 (0.5) | 22.3 (0.9) | − 0.03 (1.0) | 0.97 |
3 Months | 21.0 (90.5) | 20.9 (1.2) | 0.10 (1.3) | 0.94 | |
6 Months | 23.1 (0.6) | 23.2 (1.3) | − 0.15 (1.4) | 0.91 | |
12 months | 23.7 (0.6) | 23.6 (1.2) | 0.17 (1.3) | 0.90 | |
Overall | 22.5 (0.3) | 22.5 (0.5) | 0.02 (0.6) | 0.98 | |
Social WB | Preop | 24.2 (0.4) | 24.5 (0.6) | − 0.3 (0.7) | 0.7 |
3 months | 23.7 (0.4) | 24.9 (0.9) | − 1.2 (0.9) | 0.2 | |
6 months | 23.5 (0.4) | 24.5 (0.9) | − 1.0 (1.0) | 0.3 | |
12 months | 24.1 (0.4) | 25.0 (0.8) | − 1.0 (1.0) | 0.3 | |
Overall | 23.9 (0.2) | 24.7 (0.4) | − 0.8 (0.4) | 0.08 | |
FACT-G | Preop | 83.1 (1.4) | 81.4 (2.5) | 1.7 (2.9) | 0.5645 |
3 months | 81.7 (1.6) | 81.6 (3.4) | 0.2 (3.8) | 0.05 | |
6 months | 87.0 (1.6) | 87.4 (3.7) | − 0.4 (4.1) | 0.9 | |
12 months | 89.8 (1.8) | 89.4 (3.4) | 0.5 (3.8) | 0.9 | |
Overall | 85.4 (0.8) | 84.7 (1.6) | 0.7 (1.8) | 0.6998 | |
Cancer subscale | Preop | 21.1 (0.5) | 21.1 (0.9) | 0.08 (1.0) | 0.9382 |
3 months | 19.4 (0.5) | 18.4 (1.7) | 1.0 (1.3) | 0.5 | |
6 months | 21.0 (0.6) | 19.8 (1.2) | 1.3 (1.4) | 0.3 | |
12 months | 20.9 (0.6) | 21.1 (1.1) | − 0.1 (1.3) | 0.9 | |
Overall | 20.6 (0.3) | 20.2 (0.5) | 0.5 (0.6) | 0.4 | |
FACT-G + subscale | Preop | 104.0 (1.8) | 102.4 (3.2) | 1.6 (3.6) | 0.7 |
3 months | 101.1 (2.0) | 100.0 (4.3) | 1.1 (4.7) | 0.8 | |
6 months | 108.05 (2.0) | 107.7 (4.6) | 0.4 (5.1) | 0.9 | |
12 months | 110.8 (2.3) | 110.4 (4.2) | 0.4 (4.8) | 0.9 | |
Overall | 106.0 (1.0) | 105.0 (1.9) | 1.0 (2.2) | 0.7 | |
TOI | Preop | 60.1 (1.1) | 58.4 (2.0) | 1.6 (2.3) | 0.5 |
3 months | 59.2 (1.2) | 58.2 (2.7) | 1.0 (3.0) | 0.7 | |
6 months | 63.8 (1.3) | 62.5 (2.9) | 1.4 (3.2) | 0.7 | |
12 months | 64.5 (1.4) | 63.6 (2.6) | 0.9 (3.0) | 0.8 | |
Overall | 61.9 (0.6) | 60.6 (1.2) | 1.3 (1.4) | 0.4 | |
SF-36 mental | Preop | 38.2 (0.9) | 34.9 (1.5) | 3.3 (1.7) | 0.06 |
3 months | 37.3 (1.1) | 33.0 (2.3) | 4.3 (2.6) | 0.09 | |
6 months | 38.5 (1.1) | 38.6 (2.4) | − 0.07 (2.7) | 0.98 | |
12 months | 39.0 (1.3) | 38.5 (2.2) | 0.05 (2.6) | 0.85 | |
Overall | 38.4 (0.5) | 36.0 (1.0) | 2.36 (1.1) | 0.04 | |
SF-36 physical | Preop | 44.0 (0.9) | 45.3 (1.1) | − 1.3 (1.8) | 0.48 |
3 months | 39.1 (1.1) | 38.4 (2.4) | 0.7 (2.7) | 0.80 | |
6 months | 43.1 (1.2) | 43.9 (2.5) | − 0.9 (2.8) | 0.75 | |
12 months | 42.8 (1.3) | 44.3 (2.3) | − 1.6 (2.7) | 0.56 | |
Overall | 42.2 (0.6) | 43.1 (1.1) | − 0.9 (1.2) | 0.46 |
Appendix 4: QoL outcomes for those taking versus those not taking both opioids and psychotropic (psych) medications (meds) preoperatively
Instrument | Time | Opioids and psych meds only (SE) | Not opioids and psych meds only (SE) | Pairwise comparison (SE) | p value |
|---|---|---|---|---|---|
CES-D | Preop | 16.7 (2.1) | 10.9 (0.8) | 5.8 (2.3) | 0.01 |
3 months | 15.5 (2.3) | 10.7 (1.0) | 4.8 (2.5) | 0.06 | |
6 months | 15.4 (2.4) | 8.9 (1.0) | 6.5 (2.6) | 0.001 | |
12 months | 9.9 (2.7) | 7.3 (1.0) | 2.6 (2.9) | 0.4 | |
Overall | 14.5 (1.2) | 9.4 (0.5) | 5.1 (1.3) | < 0.001 | |
BPI (worst pain) | Preop | 3.8 (0.5) | 3.0 (0.2) | 0.8 (0.5) | 0.13 |
3 months | 3.7 (0.6) | 3.3 (0.2) | 0.4 (0.6) | 0.51 | |
6 months | 3.4 (0.6) | 2.5 (0.2) | 0.9 (0.6) | 0.15 | |
12 months | 2.9 (0.7) | 2.7 (0.3) | 0.3 (0.7) | 0.70 | |
Overall | 3.5 (0.3) | 2.9 (0.1) | 0.6 (0.3) | 0.04 | |
BPI (least pain) | Preop | 2.4 (0.3) | 1.7 (0.1) | 0.6 (0.3) | 0.05 |
3 months | 2.2 (0.4) | 1.6 (0.1) | 0.5 (0.4) | 0.2 | |
6 months | 2.2 (0.4) | 1.5 (0.2) | 0.7 (0.4) | 0.07 | |
12 months | 1.9 (0.4) | 1.4 (0.2) | 0.4 (0.4) | 0.3 | |
Overall | |||||
Functional WB | Preop | 16.6 (1.3) | 20.3 (0.5) | − 3.7 (1.4) | 0.0076 |
3 months | 16.7 (1.4) | 18.2 (0.6) | − 1.4 (1.5) | 0.35 | |
6 months | 17.9 (1.5) | 21.1 (0.6) | − 3.3 (1.6) | 0.04 | |
12 months | 20.8 (1.7) | 22.6 (0.6) | − 1.8 (1.8) | 0.33 | |
Overall | 17.9 (0.7) | 20.5 (0.3) | − 2.7 (0.8) | 0.0007 | |
Emotional WB | Preop | 14.5 (0.9) | 16.7 (0.4) | − 2.2 (1.0) | 0.03 |
3 months | 18.5 (1.0) | 19.0 (0.4) | − 0.5 (1.1) | 0.65 | |
6 months | 18.4 (1.1) | 19.7 (0.5) | − 1.3 (1.2) | 0.26 | |
12 months | 19.1 (1.3) | 19.6 (0.5) | − 0.5 (1.4) | 0.7 | |
Overall | 17.5 (0.5) | 18.8 (0.2) | − 1.3 (0.6) | 0.03 | |
Physical WB | Preop | 18.8 (1.1) | 22.8 (0.4) | − 4.0 (1.2) | 0.001 |
3 months | 19.3 (1.2) | 21.2 (0.5) | − 2.0 (1.4) | 0.14 | |
6 months | 19.8 (1.3) | 23.7 (0.5) | − 3.9 (1.4) | 0.005 | |
12 months | 21.7 (1.5) | 24.0 (0.6) | − 2.3 (1.6) | 0.15 | |
Overall | 19.8 (0.6) | 22.9 (0.3) | − 3.1 (0.7) | < 0.0001 | |
Social WB | Preop | 24.1 (0.8) | 24.3 (0.3) | − 0.3 (0.9) | 0.8 |
3 months | 23.3 (0.9) | 24.1 (0.4) | − 0.8 (1.0) | 0.5 | |
6 months | 23.3 (1.0) | 23.7 (0.4) | − 0.4 (1.0) | 0.7 | |
12 months | 24.1 (1.1) | 24.3 (0.4) | − 0.2 (1.2) | 0.9 | |
Overall | 23.7 (0.5) | 24.1 (0.2) | − 0.4 (0.5) | 0.4 | |
FACT-G | Preop | 73.9 (3.3) | 84.0 (1.3) | − 10.1 (3.6) | 0.0047 |
3 months | 77.8 (3.7) | 82.4 (1.5) | − 4.6 (4.0) | 0.2435 | |
6 months | 79.4 (3.8) | 88.5 (1.6) | − 9.0 (4.1) | 0.0274 | |
12 months | 87.0 (4.5) | 90.1 (1.7) | − 3.1 (4.8) | 0.5199 | |
Overall | 79.1 (1.9) | 86.3 (0.8) | − 7.2 (2.0) | 0.004 | |
Cancer subscale | Preop | 19.6 (1.1) | 21.4 (0.5) | − 1.8 (1.2) | 0.1 |
3 months | 18.7 (1.3) | 19.3 (0.5) | − 0.7 (1.4) | 0.6 | |
6 months | 19.8 (1.3) | 21.0 (0.5) | − 1.2 (1.4) | 0.4 | |
12 months | 19.9 (1.5) | 21.1 (0.6) | − 1.2 (1.6) | 0.5 | |
Overall | 19.5 (0.6) | 20.7 (0.3) | − 1.3 (0.7) | 0.07 | |
FACT-G + subscale | Preop | 93.5 (4.1) | 105.2 (1.6) | − 11.8 (4.5) | 0.009 |
3 months | 96.4 (4.6) | 101.7 (1.9) | − 5.3 (5.0) | 0.3 | |
6 months | 99.2 (4.7) | 109.6 (2.0) | − 10.3 (5.1) | 0.04 | |
12 months | 107.4 (5.6) | 111.2 (2.1) | 6.0 (− 3.8) | 0.5 | |
Overall | 98.7 (2.3) | 107.0 (1.0) | − 8.3 (2.5) | 0.001 | |
TOI | Preop | 52.8 (2.6) | 60.8 (1.0) | − 7.9 (2.8) | 0.005 |
3 months | 56.4 (2.9) | 59.5 (1.2) | − 3.1 (3.1) | 0.32 | |
6 months | 58.1 (3.0) | 64.6 (1.3) | − 6.5 (3.2) | 0.04 | |
12 months | 62.2 (3.5) | 64.6 (1.3) | − 2.4 (3.8) | 0.5 | |
Overall | 57.0 (1.5) | 62.4 (0.6) | − 5.4 (1.6) | 0.0008 | |
SF-36 mental | Preop | 34.3 (1.9) | 38.0 (0.8) | − 3.7 (2.1) | 0.08 |
3 months | 34.5 (2.3) | 37.0 (1.1) | − 2.6 (2.6) | 0.31 | |
6 months | 35.1 (2.5) | 39.2 (1.1) | − 4.1 (2.7) | 0.14 | |
12 months | 37.8 (2.9) | 39.1 (1.2) | − 1.2 (3.1) | 0.70 | |
Overall | 35.3 (1.2) | 38.3 (0.5) | − 3.1 (1.3) | 0.02 | |
SF-36 physical | Preop | 40.4 (2.0) | 45.1 (0.9) | − 4.7 (2.2) | 0.03 |
3 months | 38.1 (2.4) | 39.2 (1.1) | − 1.1 (2.7) | 0.67 | |
6 months | 42.9 (2.6) | 43.3 (1.2) | − 0.4 (2.9) | 0.9 | |
12 months | 43.0 (3.0) | 43.2 (1.3) | − 0.2 (3.3) | 0.95 | |
Overall | 40.6 (1.2) | 42.8 (0.5) | − 2.1 (1.3) | 0.11 |
Appendix 5
See Fig. 2.
Survival of those taking versus not taking both opioids and psychotropic medications
Appendix 6
See Fig. 3.
Survival of those taking versus not taking opioids only
Appendix 7
See Fig. 4.
Survival of those taking versus not taking psychotropic medications only
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Solsky, I., Patel, A., Valenzuela, C.D. et al. Quality-of-Life Outcomes for Patients Taking Opioids and Psychotropic Medications Before Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy. Ann Surg Oncol 31, 577–593 (2024). https://doi.org/10.1245/s10434-023-14215-7
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DOI: https://doi.org/10.1245/s10434-023-14215-7