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Assessment of the Long-Term Impact of Pancreatoduodenectomy on Health-Related Quality of Life Using the EORTC QLQ-PAN26 Module

  • Hepatobiliary Tumors
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Long-term pancreatoduodenectomy (PD) survivors have previously reported favorable quality of life (QoL). However, there has been a paucity of studies utilizing pancreas-specific modules for QoL assessment, which may uncover disability that general modules cannot detect.

Methods

The European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 and QLQ-PAN26 questionnaires were administered to PD survivors who were at least 5 years out of their operations for neoplasms (1998–2011, study cohort) and compared their scores with published preoperative scores of patients with pancreatic cancer (control cohort). The clinical relevance (CR) of differences was scored as small (5–10), moderate (10–20), or large (> 20) based on validated interpretation of clinically important differences.

Results

Of 1266 patients who underwent PD, there were 305 survivors with valid contact information, of whom 248 responded to the questionnaire (response rate 81.3%) and made up the study cohort. The median follow-up was 9.1 years (range 5.1–21.2 years). When compared with the control cohort, patients in the study cohort reported higher pancreatic pain (41.7 ± 17.6 vs. 18.1 ± 20.5, p < 0.001, CR large), sexuality dissatisfaction (63.0 ± 37.5 vs. 35.1 ± 34.3, p < 0.001, CR large), altered bowel habits (37.6 ± 30.6 vs. 20.0 ± 24.5, p < 0.001, CR moderate), and digestive symptoms (26.3 ± 29.5 vs. 18.7 ± 27.8, p = 0.002, CR small) scores. There was a higher prevalence of bloating, indigestion, and flatulence, but lower prevalence of future health worry (71.7% vs. 89.6%, p < 0.001) and limitation in planning activities (30.1% vs. 48.3%, p < 0.001) at 5 years.

Conclusion

While post-PD patients had better long-term global QoL than healthy controls, a more granular, pancreas-specific questionnaire uncovered digestive abnormalities and sexuality dissatisfaction. These data can better inform clinical decision making and provide potential areas for improvement and patient support.

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Acknowledgment

The authors would like to thank the Andrew L. Warshaw, MD Institute for Pancreatic Cancer Research for their funding support for this study.

Funding

Funding was provided by Institute for Pancreatic Cancer Research (Grant No. 0004852948).

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Author notes

  1. Zhi Ven Fong and Yurie Sekigami shared first authorship of this article.

Authors and Affiliations

  1. Department of Surgery, Massachusetts General Hospital, Boston, MA, USA

    Zhi Ven Fong MD, MPH, Yurie Sekigami MD, Motaz Qadan MD, PhD, Carlos Fernandez-del Castillo MD, Andrew L. Warshaw MD, Keith D. Lillemoe MD & Cristina R. Ferrone MD

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  1. Zhi Ven Fong MD, MPH
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  2. Yurie Sekigami MD
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  3. Motaz Qadan MD, PhD
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  4. Carlos Fernandez-del Castillo MD
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  6. Keith D. Lillemoe MD
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  7. Cristina R. Ferrone MD
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Correspondence to Cristina R. Ferrone MD.

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Fong, Z.V., Sekigami, Y., Qadan, M. et al. Assessment of the Long-Term Impact of Pancreatoduodenectomy on Health-Related Quality of Life Using the EORTC QLQ-PAN26 Module. Ann Surg Oncol 28, 4216–4224 (2021). https://doi.org/10.1245/s10434-021-09853-8

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  • DOI: https://doi.org/10.1245/s10434-021-09853-8

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