human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Objective To investigate the course of health-related quality of life ( HQL ) over time in patients with peritoneal carcinomatosis ( PC ) after complete cytoreductive surgery ( CRS ) and hyperthermic intraperitoneal chemotherapy ( HIPEC ) .  Methods Prospect i ve , single-center , nonr and omized cohort study using the European Organization for Research and Treatment of Cancer Quality of Life Question naire . Results Ninety patients who underwent CRS and HIPEC for PC in our institution were enrolled in the study . Mean age was 56 years ( range 27–77 years ) ( 61 % female ) . Primary tumor was colorectal in 21 % , ovarian in 19 % , pseudomyxoma peritonei in 16 % , an appendix tumor in 16 % , gastric cancer in 10 % , and peritoneal mesothelioma in 13 % of cases . Mean peritoneal carcinomatosis index was 22 ( range 2–39 ) . Mean global health status score was 69 ± 25 preoperatively and 55 ± 20 , 66 ± 22 , 66 ± 23 , 71 ± 23 , and 78 ± 21 at months 1 , 6 , 12 , 24 , and 36 , respectively . Physical and role function recovered significantly at 6 months and were close to baseline at the 24-month measurement . Emotional function starting from a low baseline recovered to baseline by month 12 . Cognitive and social function had slow recovery on follow-up . Fatigue , diarrhea , dyspnea , and sleep disturbance were symptoms persistent at 6-month follow-up , improving later on in survivors . Conclusions Survivors after CRS and HIPEC have postoperative quality of life similar to preoperatively , with most of the reduced elements recovering after 6–12 months . We conclude that reduced quality of life of patients after CRS and HIPEC should not be used as an argument to deny surgical therapy to these patients Background The purpose of our study was to determine the toxicity and quality of life for patients with peritoneal metastases after cytoreductive surgery ( CS ) plus hyperthermic intraperitoneal chemotherapy ( HIPC ) .  Methods From 2001 to 2005 , 35 consecutive patients with peritoneal metastases enrolled in a prospect i ve trial approved by the University of Minnesota Institutional Review Board . Their primary cancer sites included the appendix ( 19 patients ) , colon ( 7 ) , mesothelioma ( 3 ) , stomach ( 2 ) , small bowel ( 2 ) , gallbladder ( 1 ) , and unknown ( 1 ) . We performed CS in an effort to remove all or nearly all peritoneal tumor nodules . Using a closed technique , we administered hyperthermic mitomycin C into the peritoneal cavity for 90 min . Before treatment and then at 4-month postoperative intervals , we used the functional assessment of cancer therapy-colon subscale ( FACT-C ) instrument to assess the patients ’ quality of life . Results The median hospital stay was 9 days ; 12 patients were hospitalized at least 30 days or required readmission within 30 days after treatment . The postoperative mortality rate was 0 % ; adverse events occurred in 18 ( 51 % ) patients . As of December 2005 , 20 patients were alive ; 14 had died of progressive disease and 1 of an unrelated cause . The median survival time was 21.4 months . Quality of life measurements , including trial outcome index ( TOI ) , FACT-colon , and FACT-general , returned to baseline 4 months after treatment and were significantly improved at 8 and 12 months . Conclusions Despite early toxicity , CS plus HIPC may prolong the overall survival rate of patients with peritoneal metastases and improve quality of life measurements Background Cytoreductive surgery ( CS ) with hyperthermic intraperitoneal chemotherapy ( HIPEC ) for peritoneal metastases can alleviate symptoms and prolong survival at the expense of morbidity and quality of life ( QoL ) . This study aim ed to monitor QoL and outcomes before and after HIPEC . Methods A prospect i ve QoL trial of patients who underwent HIPEC for peritoneal metastases from 2000 to 2015 was conducted . The patients completed the Medical Outcomes Study 36-Item Short-Form Health Survey ( SF-36 ) , the Functional Assessment of Cancer Therapy + Colon Subscale ( FACT-C ) , the Brief Pain Inventory , the Center for Epidemiologic Studies Depression scale , and the Eastern Cooperative Oncology Group ( ECOG ) performance status at baseline , then 3 , 6 , 12 , and 24 months after HIPEC . The trial outcome index ( TOI ) was analyzed . Proportional hazards modeled the effect of baseline QoL on survival . Results The 598 patients ( 53.8 % female ) in the study had a mean age of 53.3 years . The overall 1-year survival rate was 76.8 % , and the median survival period was 2.9 years . The findings showed a minor morbidity rate of 29.3 % , a major morbidity rate of 21.7 % , and a 30-day mortality rate of 3.5 % . The BPI ( p < 0.0001 ) and worst pain ( p = 0.004 ) increased at 3 months but returned to baseline at 6 months . After CS + HIPEC , FACT-C emotional well-being , SF-36 mental component score , and emotional health improved ( all p < 0.001 ) . Higher baseline FACT-General ( hazard ratio [ HR ] , 0.92 ; 95 % confidence interval [ CI ] , 0.09–0.96 ) , FACT-C ( HR , 0.73 ; 95 % CI 0.65–0.83 ) , physical well-being ( HR , 0.71 ; 95 % CI 0.64–0.78 ) , TOI ( HR , 0.87 ; 95 % CI 0.84–0.91 ) , and SF-36 vitality ( HR , 0.88 ; 95 % CI 0.83–0.92 ) were associated with improved survival ( all p < 0.001 ) . Higher baseline BPI ( HR , 1.1 ; 95 % CI 1.05–1.14 ; p < 0.0001 ) , worst pain ( HR , 1.06 ; 95 % CI 1.01–1.10 ; p = 0.01 ) , and ECOG ( HR , 1.74 ; 95 % CI 1.50–2.01 ; p < 0.0001 ) were associated with worse survival . Conclusions Although HIPEC is associated with morbidity and detriments to QoL , recovery with good overall QoL typically occurs at or before 6 months . Baseline QoL is associated with morbidity , mortality , and survival after HIPEC Introduction Cytoreductive surgery ( CRS ) and hyperthermic intraperitoneal chemotherapy ( HIPEC ) is an effective treatment for selected patients with peritoneal surface malignancies ( PSM ) . Although it can have significant morbidity , perioperative mortality is low . Little is known about whether major complications after CRS/HIPEC have a lasting impact on patients ’ quality of life ( QOL ) . Methods We retrospectively review ed data from a prospect ively collected data base on patients treated with CRS/HIPEC for PSM ( 2011–2014 ) . Patients with CRS/HIPEC and 6-month QOL evaluation were included . Major perioperative complications ( Clavien – Dindo grade 3/4 ) were the primary independent variable . QOL was evaluated using the vali date d EORTC QLQ-C30 score . The primary outcome was 6-month global health score . Secondary outcomes were individual functional and symptom domains . Results Forty-two patients were analyzed . Median age was 57.5 ; 64 % were female . Origin of PSM was appendix ( 55 % ) , colorectal ( 38 % ) , mesothelioma ( 5 % ) , and small bowel ( 2 % ) . Fourteen patients ( 33 % ) had major ( grade 3/4 ) complications . Median length of stay was 16 days ; patients experiencing major complications had significantly increased length of stay ( 35.5 vs. 13 days , p < 0.01 ) . Major complications included intra-abdominal abscess ( 9.5 % ) , bleeding ( 9.5 % ) , symptomatic pleural effusion ( 7.1 % ) , anastomotic leaks ( 7.1 % ) , and renal failure ( 2.4 % ) . The average global health score at 6 months was 68.1 . The worst-rated symptom scores at 6 months were diarrhea ( 39.8 ) and fatigue ( 35.4 ) . There were no significant differences in 6-month QOL scores between patients with and without major complications , globally or in specific domains . Conclusions Although major complications are common after CRS/HIPEC , QOL at 6 months recovers and is similar to those without major complications Background : Because of specific method ological difficulties in conducting r and omized trials , surgical research remains dependent predominantly on observational or non‐r and omized studies . Few vali date d instruments are available to determine the method ological quality of such studies either from the reader 's perspective or for the purpose of meta‐ analysis . The aim of the present study was to develop and vali date such an instrument INTRODUCTION Cytoreductive Surgery ( CRS ) and Hyperthermic Intraperitoneal Chemotherapy ( HIPEC ) have demonstrated promising results in the treatment of peritoneal carcinomatosis ( PC ) . The purpose of this study was to assess the impact of this combined procedure on quality of life ( QoL ) . MATERIAL S AND METHODS A prospect i ve single centre study of 216 consecutive patients treated with CRS and HIPEC  was conducted using the Gastro-Intestinal Quality of Life Index question naire ( GIQLI ) , completed preoperatively and at 1 , 3 , 6 and 12 months . RESULTS Question naire compliance was 81 % , 90 % , 89 % , 89 % and 74 % at baseline , 1 , 3 , 6 and 12 months respectively . QoL was significantly decreased up to 6 months and returned to baseline at 12 months . In multivariate analysis , factors decreasing QoL were origin of PC at 3 months , presence of stoma at 6 months and length of surgery over 270 min and disease recurrence at 12 months . CONCLUSIONS Despite morbidity associated with CRS and HIPEC , QoL returned to baseline at one year after surgery . This treatment strategy should be considered for the treatment of peritoneal carcinomatosis AIMS This study assessed the functional status and quality of life ( QOL ) of patients with disseminated peritoneal cancer ( DPC ) before and after cytoreductive surgery plus intraperitoneal hyperthermic chemotherapy ( IPHC ) .  METHODS Patients with confirmed or suspected diagnosis of gastro-intestinal cancer including stomach , pancreas , hepatobiliary and colorectal cancer with peritoneal implants were enrolled in the study . Sixty-four patients completed the Functional Assessment of Cancer Therapy-Colon ( FACT-C ) scale and several other instruments at baseline . Forty-eight , 40 , 39 and 31 patients were assessed at approximately 2 weeks post-surgery , and 3 , 6 and 12 months respectively . RESULTS There was a significant overall effect on the physical ( P=0.0025 ) , emotional ( P<0.0001 ) and functional well-being ( P=0.0044 ) subscales and the FACT-C ( P=0.0076 ) . Physical and functional well-being scores decreased at post-surgery follow-up and increased relative to baseline at 3 , 6 and 12 months . Nineteen per cent , 46 % , 59 % and 74 % of patients resumed greater than 50 % of their normal activities post-operatively at 3 , 6 and 12 months respectively . A percentage of patients reported depressive symptoms : baseline ( 28 % ) , post-operatively ( 33 % ) , 3 months ( 23 % ) , 6 months ( 21 % ) and 12 months ( 29 % ) . CONCLUSIONS Cytoreductive surgery followed by IPHC was well tolerated . Most patients returned to baseline or better levels of functioning within 3 months post-treatment Background / Aims : Cytoreductive surgery and hyperthermic intraperitoneal chemoperfusion ( HIPEC ) can improve survival in selected patients with peritoneal carcinomatosis , but bear a significant risk of perioperative morbidity . The aim of this study was to prospect ively evaluate the quality of life ( QoL ) following cytoreduction and HIPEC . Methods : In this study including 40 patients ( 65 % females ) with different primary tumors , the EORTC QLQ-C30 question naire was applied prior to CS and HIPEC as well as 3 , 9 , and 18 months postoperatively . Results : Global health status was not impaired significantly following HIPEC .  Scales and symptom scores that deteriorated 3 months postoperatively ( p < 0.05 ) , that is , physical , role , and social functions as well as fatigue 
    Output:
    
agent
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Objective To investigate the course of health-related quality of life ( HQL ) over time in patients with peritoneal carcinomatosis ( PC ) after complete cytoreductive surgery ( CRS ) and hyperthermic intraperitoneal chemotherapy ( HIPEC ) .  Methods Prospect i ve , single-center , nonr and omized cohort study using the European Organization for Research and Treatment of Cancer Quality of Life Question naire . Results Ninety patients who underwent CRS and HIPEC for PC in our institution were enrolled in the study . Mean age was 56 years ( range 27–77 years ) ( 61 % female ) . Primary tumor was colorectal in 21 % , ovarian in 19 % , pseudomyxoma peritonei in 16 % , an appendix tumor in 16 % , gastric cancer in 10 % , and peritoneal mesothelioma in 13 % of cases . Mean peritoneal carcinomatosis index was 22 ( range 2–39 ) . Mean global health status score was 69 ± 25 preoperatively and 55 ± 20 , 66 ± 22 , 66 ± 23 , 71 ± 23 , and 78 ± 21 at months 1 , 6 , 12 , 24 , and 36 , respectively . Physical and role function recovered significantly at 6 months and were close to baseline at the 24-month measurement . Emotional function starting from a low baseline recovered to baseline by month 12 . Cognitive and social function had slow recovery on follow-up . Fatigue , diarrhea , dyspnea , and sleep disturbance were symptoms persistent at 6-month follow-up , improving later on in survivors . Conclusions Survivors after CRS and HIPEC have postoperative quality of life similar to preoperatively , with most of the reduced elements recovering after 6–12 months . We conclude that reduced quality of life of patients after CRS and HIPEC should not be used as an argument to deny surgical therapy to these patients Background The purpose of our study was to determine the toxicity and quality of life for patients with peritoneal metastases after cytoreductive surgery ( CS ) plus hyperthermic intraperitoneal chemotherapy ( HIPC ) .  Methods From 2001 to 2005 , 35 consecutive patients with peritoneal metastases enrolled in a prospect i ve trial approved by the University of Minnesota Institutional Review Board . Their primary cancer sites included the appendix ( 19 patients ) , colon ( 7 ) , mesothelioma ( 3 ) , stomach ( 2 ) , small bowel ( 2 ) , gallbladder ( 1 ) , and unknown ( 1 ) . We performed CS in an effort to remove all or nearly all peritoneal tumor nodules . Using a closed technique , we administered hyperthermic mitomycin C into the peritoneal cavity for 90 min . Before treatment and then at 4-month postoperative intervals , we used the functional assessment of cancer therapy-colon subscale ( FACT-C ) instrument to assess the patients ’ quality of life . Results The median hospital stay was 9 days ; 12 patients were hospitalized at least 30 days or required readmission within 30 days after treatment . The postoperative mortality rate was 0 % ; adverse events occurred in 18 ( 51 % ) patients . As of December 2005 , 20 patients were alive ; 14 had died of progressive disease and 1 of an unrelated cause . The median survival time was 21.4 months . Quality of life measurements , including trial outcome index ( TOI ) , FACT-colon , and FACT-general , returned to baseline 4 months after treatment and were significantly improved at 8 and 12 months . Conclusions Despite early toxicity , CS plus HIPC may prolong the overall survival rate of patients with peritoneal metastases and improve quality of life measurements Background Cytoreductive surgery ( CS ) with hyperthermic intraperitoneal chemotherapy ( HIPEC ) for peritoneal metastases can alleviate symptoms and prolong survival at the expense of morbidity and quality of life ( QoL ) . This study aim ed to monitor QoL and outcomes before and after HIPEC . Methods A prospect i ve QoL trial of patients who underwent HIPEC for peritoneal metastases from 2000 to 2015 was conducted . The patients completed the Medical Outcomes Study 36-Item Short-Form Health Survey ( SF-36 ) , the Functional Assessment of Cancer Therapy + Colon Subscale ( FACT-C ) , the Brief Pain Inventory , the Center for Epidemiologic Studies Depression scale , and the Eastern Cooperative Oncology Group ( ECOG ) performance status at baseline , then 3 , 6 , 12 , and 24 months after HIPEC . The trial outcome index ( TOI ) was analyzed . Proportional hazards modeled the effect of baseline QoL on survival . Results The 598 patients ( 53.8 % female ) in the study had a mean age of 53.3 years . The overall 1-year survival rate was 76.8 % , and the median survival period was 2.9 years . The findings showed a minor morbidity rate of 29.3 % , a major morbidity rate of 21.7 % , and a 30-day mortality rate of 3.5 % . The BPI ( p < 0.0001 ) and worst pain ( p = 0.004 ) increased at 3 months but returned to baseline at 6 months . After CS + HIPEC , FACT-C emotional well-being , SF-36 mental component score , and emotional health improved ( all p < 0.001 ) . Higher baseline FACT-General ( hazard ratio [ HR ] , 0.92 ; 95 % confidence interval [ CI ] , 0.09–0.96 ) , FACT-C ( HR , 0.73 ; 95 % CI 0.65–0.83 ) , physical well-being ( HR , 0.71 ; 95 % CI 0.64–0.78 ) , TOI ( HR , 0.87 ; 95 % CI 0.84–0.91 ) , and SF-36 vitality ( HR , 0.88 ; 95 % CI 0.83–0.92 ) were associated with improved survival ( all p < 0.001 ) . Higher baseline BPI ( HR , 1.1 ; 95 % CI 1.05–1.14 ; p < 0.0001 ) , worst pain ( HR , 1.06 ; 95 % CI 1.01–1.10 ; p = 0.01 ) , and ECOG ( HR , 1.74 ; 95 % CI 1.50–2.01 ; p < 0.0001 ) were associated with worse survival . Conclusions Although HIPEC is associated with morbidity and detriments to QoL , recovery with good overall QoL typically occurs at or before 6 months . Baseline QoL is associated with morbidity , mortality , and survival after HIPEC Introduction Cytoreductive surgery ( CRS ) and hyperthermic intraperitoneal chemotherapy ( HIPEC ) is an effective treatment for selected patients with peritoneal surface malignancies ( PSM ) . Although it can have significant morbidity , perioperative mortality is low . Little is known about whether major complications after CRS/HIPEC have a lasting impact on patients ’ quality of life ( QOL ) . Methods We retrospectively review ed data from a prospect ively collected data base on patients treated with CRS/HIPEC for PSM ( 2011–2014 ) . Patients with CRS/HIPEC and 6-month QOL evaluation were included . Major perioperative complications ( Clavien – Dindo grade 3/4 ) were the primary independent variable . QOL was evaluated using the vali date d EORTC QLQ-C30 score . The primary outcome was 6-month global health score . Secondary outcomes were individual functional and symptom domains . Results Forty-two patients were analyzed . Median age was 57.5 ; 64 % were female . Origin of PSM was appendix ( 55 % ) , colorectal ( 38 % ) , mesothelioma ( 5 % ) , and small bowel ( 2 % ) . Fourteen patients ( 33 % ) had major ( grade 3/4 ) complications . Median length of stay was 16 days ; patients experiencing major complications had significantly increased length of stay ( 35.5 vs. 13 days , p < 0.01 ) . Major complications included intra-abdominal abscess ( 9.5 % ) , bleeding ( 9.5 % ) , symptomatic pleural effusion ( 7.1 % ) , anastomotic leaks ( 7.1 % ) , and renal failure ( 2.4 % ) . The average global health score at 6 months was 68.1 . The worst-rated symptom scores at 6 months were diarrhea ( 39.8 ) and fatigue ( 35.4 ) . There were no significant differences in 6-month QOL scores between patients with and without major complications , globally or in specific domains . Conclusions Although major complications are common after CRS/HIPEC , QOL at 6 months recovers and is similar to those without major complications Background : Because of specific method ological difficulties in conducting r and omized trials , surgical research remains dependent predominantly on observational or non‐r and omized studies . Few vali date d instruments are available to determine the method ological quality of such studies either from the reader 's perspective or for the purpose of meta‐ analysis . The aim of the present study was to develop and vali date such an instrument INTRODUCTION Cytoreductive Surgery ( CRS ) and Hyperthermic Intraperitoneal Chemotherapy ( HIPEC ) have demonstrated promising results in the treatment of peritoneal carcinomatosis ( PC ) . The purpose of this study was to assess the impact of this combined procedure on quality of life ( QoL ) . MATERIAL S AND METHODS A prospect i ve single centre study of 216 consecutive patients treated with CRS and HIPEC  was conducted using the Gastro-Intestinal Quality of Life Index question naire ( GIQLI ) , completed preoperatively and at 1 , 3 , 6 and 12 months . RESULTS Question naire compliance was 81 % , 90 % , 89 % , 89 % and 74 % at baseline , 1 , 3 , 6 and 12 months respectively . QoL was significantly decreased up to 6 months and returned to baseline at 12 months . In multivariate analysis , factors decreasing QoL were origin of PC at 3 months , presence of stoma at 6 months and length of surgery over 270 min and disease recurrence at 12 months . CONCLUSIONS Despite morbidity associated with CRS and HIPEC , QoL returned to baseline at one year after surgery . This treatment strategy should be considered for the treatment of peritoneal carcinomatosis AIMS This study assessed the functional status and quality of life ( QOL ) of patients with disseminated peritoneal cancer ( DPC ) before and after cytoreductive surgery plus intraperitoneal hyperthermic chemotherapy ( IPHC ) .  METHODS Patients with confirmed or suspected diagnosis of gastro-intestinal cancer including stomach , pancreas , hepatobiliary and colorectal cancer with peritoneal implants were enrolled in the study . Sixty-four patients completed the Functional Assessment of Cancer Therapy-Colon ( FACT-C ) scale and several other instruments at baseline . Forty-eight , 40 , 39 and 31 patients were assessed at approximately 2 weeks post-surgery , and 3 , 6 and 12 months respectively . RESULTS There was a significant overall effect on the physical ( P=0.0025 ) , emotional ( P<0.0001 ) and functional well-being ( P=0.0044 ) subscales and the FACT-C ( P=0.0076 ) . Physical and functional well-being scores decreased at post-surgery follow-up and increased relative to baseline at 3 , 6 and 12 months . Nineteen per cent , 46 % , 59 % and 74 % of patients resumed greater than 50 % of their normal activities post-operatively at 3 , 6 and 12 months respectively . A percentage of patients reported depressive symptoms : baseline ( 28 % ) , post-operatively ( 33 % ) , 3 months ( 23 % ) , 6 months ( 21 % ) and 12 months ( 29 % ) . CONCLUSIONS Cytoreductive surgery followed by IPHC was well tolerated . Most patients returned to baseline or better levels of functioning within 3 months post-treatment Background / Aims : Cytoreductive surgery and hyperthermic intraperitoneal chemoperfusion ( HIPEC ) can improve survival in selected patients with peritoneal carcinomatosis , but bear a significant risk of perioperative morbidity . The aim of this study was to prospect ively evaluate the quality of life ( QoL ) following cytoreduction and HIPEC . Methods : In this study including 40 patients ( 65 % females ) with different primary tumors , the EORTC QLQ-C30 question naire was applied prior to CS and HIPEC as well as 3 , 9 , and 18 months postoperatively . Results : Global health status was not impaired significantly following HIPEC .  Scales and symptom scores that deteriorated 3 months postoperatively ( p < 0.05 ) , that is , physical , role , and social functions as well as fatigue 
    Output:
    