Patients were followed in clinic 3, 6, 12, 18, and 24 months after surgery. Short Form-36, together with the two symptom-specific instruments– EORTC-C30, and EORTC-CR38 were used to assess the quality of life. Seventy percent of patients had one or more complications during or after surgery, but all had recovered; 14% had an asymptomatic recurrence detected within two years. No significant decrease was observed in the scores on

the Short Form-36 Questionnaire scales of physical dimension and role physical three months after surgery, only returning to Rapamycin structure normal after six Inhibitors,research,lifescience,medical months. No measurable decrease in QoL was found after 12 and 18 months. Tuttle et al. studied 35 consecutive patients with peritoneal metastases enrolled in a prospective trial from 2001 to 2005. Inhibitors,research,lifescience,medical Before treatment and then at 4-month postoperative intervals, the authors used the FACT-C, FACT-G and TOI instrument to assess the patients quality of life (45). Quality of life measurements returned to baseline

4 months after treatment and were significantly improved Inhibitors,research,lifescience,medical at 8 and 12 months. Functional well being scores and emotional well being scores improved significantly at 8 and 12 months when compared to baseline. Patients treated by MMC dose >30 mg were significantly more likely to have an adverse event compared to low dose MMC treated patients. In their study, many patients were still receiving systemic chemotherapy 4 months after CRS and HIPEC which Sunitinib c-Kit decreased their Inhibitors,research,lifescience,medical quality of life scores. The authors found the QoL of patients after CRS and HIPEC at 12 months is similar to the QoL of colorectal cancer patients who underwent curative resection of primary tumors. Summary Peritoneal metastases from cancer are a common and unfortunate pattern of recurrent metastatic disease for many cancers arising from the gastrointestinal tract or the peritoneal lining. Despite advance in chemotherapy survival is limited; many patients suffer from

a marked morbidity from tumor progression in the abdominal Inhibitors,research,lifescience,medical cavity. CRS and HIPEC provide a promising and potentially therapeutic option for selected patients with peritoneal surface metastases. Short term mortality and morbidity have been reduced in recent years because of better Batimastat patient selection and improvements in operative technique and post-operative management. Because CRS and HIPEC have associated morbidity it is important to assess the success of treatment in terms of both quality and longevity of life. In most clinical studies, patient HRQoL status returns to baseline and is generally improve for up to a year after treatment. Acknowledgements Disclosure: The authors declare no conflict of interest.
Medical records of all patients treated at Duke University Hospitals who were diagnosed with adenocarcinoma of the ampulla of Vater from 1976 to 2010 were analyzed with Institutional Review Board (IRB) approval.