The role of oncovascular surgery as a tool for quality of life improvement in patients with locally advanced tumors

BACKGROUND: Oncovascular surgery (OVS) is a complex surgical approach involving resection of tumors with major vascular involvement, typically offered to patients initially considered inoperable. Despite its radical nature, the effect of OVS on long-term quality of life (QoL) remains insufficiently studied. To evaluate and compare the QoL in patients with advanced tumors involving major vessels who underwent OVS versus those treated with palliative chemotherapy and/or radiotherapy.METHODS: This prospective, observational case-control study included 102 patients treated between 2018 and 2023 in two Bulgarian hospitals. Forty-one patients underwent OVS (intervention group), and sixty-one received only chemoradiotherapy (control group). QoL was assessed at baseline, six months, and twelve months using the EQ-5D-5L instrument, including index scores, five health domains, and visual analogue scale (VAS).RESULTS: Baseline QoL did not differ significantly between groups. At both follow-up points, patients in the OVS group demonstrated significantly higher EQ-5D index scores and better outcomes in all health dimensions. VAS self-rated health also improved or remained stable in the OVS group, while the control group showed progressive deterioration across all metrics.CONCLUSIONS: OVS helps preserve, and in some aspects improve, the QoL in patients with locally advanced malignancies involving major vessels. In contrast, palliative treatment alone is associated with a marked decline in QoL. These findings support the integration of OVS into multidisciplinary cancer care for selected patients and provide a basis for further large-scale research.