Impact of pancreatectomy on long‐term patient‐reported symptoms and quality of life in recurrence‐free survivors of pancreatic and periampullary neoplasms

• Published in: Journal of surgical oncology 2017-02, Vol.115 (2), p.144-150
• Main Authors: Cloyd, Jordan M., Tran Cao, Hop S., Petzel, Maria Q.B., Denbo, Jason W., Parker, Nathan H., Nogueras‐González, Graciela M., Liles, Joseph S., Kim, Michael P., Lee, Jeffrey E., Vauthey, Jean‐Nicolas, Aloia, Thomas A., Fleming, Jason B., Katz, Matthew H.G.
• Format: Article
• Language: English
• Subjects: Adenocarcinoma - pathology; Adenocarcinoma - surgery; Adult; Aged; Aged, 80 and over; Carcinoma, Neuroendocrine - pathology; Carcinoma, Neuroendocrine - surgery; Carcinoma, Pancreatic Ductal - pathology; Carcinoma, Pancreatic Ductal - surgery; Common Bile Duct Neoplasms - pathology; Common Bile Duct Neoplasms - surgery; Cross-Sectional Studies; Female; Follow-Up Studies; Humans; Male; Middle Aged; Neoplasm Recurrence, Local - pathology; Neoplasm Recurrence, Local - surgery; Neoplasm Staging; Pancreatectomy - mortality; pancreatic cancer; Pancreatic Neoplasms - pathology; Pancreatic Neoplasms - surgery; pancreatic neuroendocrine tumor; pancreatoduodenectomy; Prognosis; Prospective Studies; Quality of Life; Severity of Illness Index; Survival Rate; Survivors; survivorship; whipple
• ISSN: 0022-4790; 1096-9098
• DOI: 10.1002/jso.24499

Background Long term patient‐reported symptoms and quality of life (QOL) are important outcome metrics following cancer operations, but have been poorly described in patients who have previously undergone pancreatectomy. Methods We conducted a cross‐sectional survey of recurrence‐free survivors of pancreatic ductal adenocarcinoma, periampullary carcinomas, and pancreatic neuroendocrine tumors who had undergone prior pancreatectomy. QOL and symptom burden were measured using the Functional Assessment of Cancer Therapy–Hepatobiliary Questionnaire, and psychosocial distress was measured using the Hospital Anxiety and Depression Scale. Results Of 331 eligible patients surveyed, 217 (66%) participated at a median of 53.3 (range, 7.6–214.8) months following pancreatoduodenectomy (PD, n = 165) or distal pancreatectomy (DP, n = 52). Among all patients, overall QOL scores were favorable and influenced by race, histology, and type of surgery. The most common significant symptoms reported were fatigue (82%), back pain (32%), and difficulty with digestion (31%). In general, PD survivors reported better QOL, lower levels of anxiety/depression, greater levels of diarrhea, and improved appetite, constipation, fatigue, anxiety, and depression (P