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Patient-Reported Quality of Life After Pancreatic and Liver Surgery

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Patient Reported Outcomes and Quality of Life in Surgery

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Abstract

Background: Surgery for cancers of the hepatopancreatobiliary (HPB) system is associated with high perioperative morbidity and marginal improvement in overall survival. Health-related Quality of Life (HRQOL) is an increasingly important outcome measure in the management of HPB cancers. The aim of this study is to assess the impact of surgery on HRQOL in patients undergoing resections for pancreatic and liver cancers.

Methods: A systematic review of the literature was performed according to the PRISMA guidelines. A systematic search of all the English literature available in Medline, Ovid Embase and Scopus was performed. All studies reporting HRQOL using validated questionnaires in pancreatic and liver cancer patients undergoing surgery were included.

Results: Forty three studies were included. Nineteen studies comprising a total of 1855 patients and 15 different validated instruments were used to report HRQOL in patients who had surgery for pancreatic cancer. Twenty four studies comprising a total of 3654 patients and 20 different validated instruments were used to report HRQOL in patients who had surgery for liver cancer. Overall, a pattern of short-term negative impact on QOL after surgery which was not associated with irreversible impairment was demonstrated. Functional deterioration in the immediate post-operative period improved after 3 months and returned to baseline by 6 months. Recurrence, advanced pTNM and comorbid anxiety and depression had an inverse correlation with QOL in liver resections. Type and extent of surgery as well as presence of pancreatic insufficiency can be relevant prognosticators of HRQOL in pancreatic cancer.

Conclusions: HRQOL scores tend to deteriorate after surgery but recover to baseline in the long-term. The findings of this study aim to contribute positively towards shared decision-making between patient and clinician and are useful to inform patient’s expectations on QOL after surgery in HPB cancer.

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Authors and Affiliations

  1. Imperial College London, London, UK

    Nicole E. James, Tamara M. H. Gall & Mikael H. Sodergren

  2. Department of Surgery & Cancer, Imperial College London, Hammersmith Hospital, London, UK

    Eliana Kalakouti, Swathikan Chidambaram, Tamara M. H. Gall & Mikael H. Sodergren

Authors
  1. Nicole E. James
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  2. Eliana Kalakouti
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  3. Swathikan Chidambaram
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  4. Tamara M. H. Gall
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  5. Mikael H. Sodergren
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Correspondence to Mikael H. Sodergren .

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Editors and Affiliations

  1. Surgery and Cancer, Imperial College London, London, UK

    Thanos Athanasiou

  2. Surgery and Cancer, Imperial College London, London, UK

    Vanash Patel

  3. Surgery and Cancer, Imperial College London, London, UK

    Ara Darzi

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James, N.E., Kalakouti, E., Chidambaram, S., Gall, T.M.H., Sodergren, M.H. (2023). Patient-Reported Quality of Life After Pancreatic and Liver Surgery. In: Athanasiou, T., Patel, V., Darzi, A. (eds) Patient Reported Outcomes and Quality of Life in Surgery. Springer, Cham. https://doi.org/10.1007/978-3-031-27597-5_9

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  • DOI: https://doi.org/10.1007/978-3-031-27597-5_9

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  • Print ISBN: 978-3-031-27596-8

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