Discussion
colorectal cancer, fatigue, loss of taste, CRS, hair loss, colorectal peritoneal metastases, loss of appetite, hair loss
ESOPHAGEAL CANCER, METASTATIC COLORECTAL CANCER, COLORECTAL CANCER, LOSS OF APPETITE, HAIR LOSS
In patients with resectable colorectal peritoneal metastases, randomized to perioperative systemic therapy or CRS–HIPEC alone, all predefined PROs (i.e., visual analog scale, global health status, physical functioning, fatigue, C30 summary score) were comparable between both arms at baseline and 3 and 6 months postoperatively. These PROs returned to baseline at 3 or 6 months postoperatively in both arms. Secondary explorative analyses in the experimental arm showed statistically significant and clinically relevant worsening of fatigue, hair loss, loss of taste, and loss of appetite after neoadjuvant treatment. Except for loss of appetite, these PROs returned to baseline at 3 or 6 months postoperatively.To the knowledge of the authors, the present study is the first to compare PROs between perioperative systemic therapy or CRS–HIPEC alone for resectable colorectal peritoneal metastases. Findings of the present study provide relevant insight in the burden of perioperative systemic therapy in this setting and show acceptable treatment tolerability. Together with the previously demonstrated safety and feasibility of perioperative systemic therapy in patients with resectable colorectal peritoneal metastases,A recent systematic review identified 14 other studies reporting PROs in patients undergoing CRS–HIPEC.The present study showed worsening of fatigue, loss of appetite, hair loss, and loss of taste after neoadjuvant treatment. Although these symptoms are generally recognized as common observer-reported side effects of systemic therapy for colorectal cancer in clinical trials,The main strength of the present study is the overall response rate of 87%, which is high compared with other PRO studies: 65% in a randomized trial of neoadjuvant chemoradiotherapy and surgery versus surgery alone in esophageal cancer, and 65% in a systematic review of metastatic colorectal cancer trials.