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Fear of Cancer Recurrence after Curative Pancreatectomy: A Cross-sectional Study in Survivors of Pancreatic and Periampullary Tumors

  • Pancreatic Tumors
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Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Fear of disease recurrence is well documented among cancer survivors, but its significance among patients treated for solid pancreatic and periampullary neoplasms is unknown despite the known risk of recurrence associated with these tumors. We hypothesized that fear of cancer recurrence (FCR) represents a common source of psychosocial distress in this population and sought to characterize subgroups for whom FCR might represent a target for intervention to improve quality of life.

Methods

We conducted a cross-sectional study of FCR in patients who were disease-free after potentially curative pancreatectomy for ductal or periampullary adenocarcinoma or pancreatic neuroendocrine tumor. We assessed seven discrete dimensions of FCR using the Fear of Recurrence Inventory and evaluated quality of life and psychosocial distress using the Functional Assessment of Cancer Therapy-Hepatobiliary Questionnaire and the Hospital Anxiety and Depression Scale.

Results

Of 354 eligible patients, 240 (68 %) participated in the study a median of 48 months after potentially curative pancreatectomy. An FCR severity score indicative of frequent fearful thoughts, emotional disturbance and functional impairment was identified in 37, 28, and 35 % of patients with pancreatic adenocarcinoma, nonpancreatic periampullary adenocarcinoma, and pancreatic neuroendocrine tumor, respectively. Anxiety (P < 0.001) and low quality of life (P = 0.028) were independently associated with a clinically significant level of FCR, but histopathologic diagnosis and clinicopathologic markers of prognosis were not.

Conclusions

FCR represents a significant concern for one-third of patients after curative surgery for a pancreatic or periampullary tumor, regardless of their actual likelihood of recurrence or disease-related death.

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Acknowledgment

Supported in part by the Khalifa Bin Zayed Al Nahyan Foundation and the Various Donor Pancreatic Research Fund at the University of Texas MD Anderson Cancer Center.

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Authors and Affiliations

  1. Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Maria Q. B. Petzel RD, Nathan H. Parker BS, Jeffrey E. Lee MD, Peter W. T. Pisters MD, Jean-Nicolas Vauthey MD, Jason B. Fleming MD & Matthew H. G. Katz MD

  2. Department of Clinical Nutrition, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Maria Q. B. Petzel RD

  3. Department of Psychiatry, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Alan D. Valentine MD

  4. Institut universitaire de cardiologie et de pneumologie de Québec, Université Laval, Quebec, QC, Canada

    Sébastien Simard PhD

  5. Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Graciela M. Nogueras-Gonzalez MPH

Authors
  1. Maria Q. B. Petzel RD
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  2. Nathan H. Parker BS
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  3. Alan D. Valentine MD
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  4. Sébastien Simard PhD
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  5. Graciela M. Nogueras-Gonzalez MPH
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  6. Jeffrey E. Lee MD
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  7. Peter W. T. Pisters MD
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  8. Jean-Nicolas Vauthey MD
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  9. Jason B. Fleming MD
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  10. Matthew H. G. Katz MD
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Corresponding author

Correspondence to Matthew H. G. Katz MD.

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Petzel, M.Q.B., Parker, N.H., Valentine, A.D. et al. Fear of Cancer Recurrence after Curative Pancreatectomy: A Cross-sectional Study in Survivors of Pancreatic and Periampullary Tumors. Ann Surg Oncol 19, 4078–4084 (2012). https://doi.org/10.1245/s10434-012-2566-1

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  • DOI: https://doi.org/10.1245/s10434-012-2566-1

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